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KMID : 0978920080090040409
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Korean Journal of Clinical Geriatrics
2008 Volume.9 No. 4 p.409 ~ p.416
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Clinical Review of Acute Appendicitis in Elderly
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Seo Keun-young
Kang Jee-Hyun
Park Seon-young
Yu Byung-Yeon
Choi Won-Jun
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Abstract
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Background: Acute appendeicitis is a common disease in all age. But there is extended admission period and high mortality rate in old age because of delayed diagnosis due to vague initial symptoms
and social reasons. This research is aimed at being of help to reducing misdiagnosis and complication by studying clinical traits of old aged acute appendicitis.
Methods: Retrospective analyzed 505 of 3,293 cases of pathologically confirmed acute appendicitis at a university hospital from February 2003 to March 2007.
Results: There was 338 cases under age of 65, 167 cases over age of 65. The onset of symtoms was shorter in old age (2.42±3.61/2.20±2.64, P=0.000). The rate visited private clinic was higher in age over 65 (76%/61.1%, P=0.001). Physical eaxmination did not show a significant difference.
In groups of age over 65, WBC count was low (13.30±10.18/11.57±4.07, P=0.035), the rate of nomal WBC count was high (35.3%, P=0.003). Perforation was high in groups of age over 65 (15.1%/33.5%,
P=0.000). Abscess was high, but was not statistically significant (14.4%/9.2% P=0.095). Histologic finding was in order of suppurative, gangraneous, exudative in age over 65. And the order is suppurative,
exudative, gangraneous in age under 65 (P=0.000).
Conclusion: In old age, diagnosis of acute appendicitis is difficult due to variable gastrointestinal symptoms and normal leukocytosis count, but at the time of diagnosis, the rate of complication is high. So, early and accurate diagnosis of acute appendicitis in old age group is important. Role of family medicine doctor whose performing primary care is important.
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KEYWORD
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Appendicitis, Inteastinal perforation, Aged
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