Ruptured appendicitis is a place for clinical judgement in the Elderly patient.

Abstract

Background and Objectives : Appendicitis is an uncommon disease in the elderly, and is subject to delayed presentation and diagnosis result in highe perforation.This study evaluated clinical and paraclinical data in the elderly patients.

Patients and Methods : Medical Records of patients who diagnosed of appendicitis and admited in Trat Hospital between October 1, 2000 and March 31, 2006 were reviewed.The elderly patients with appendicitis were selected and analized clinical and paraclinical data.

Results : The medical records of 2,384 cases with appendicitis were reviewed. Ruptured Appendicitis was 407 cases (17.07 percent), and 52 of 172 elderly patients (30.23 percent) had ruptured appendicitis at the time of operation. Overall of patients presented typically. Delays occuring before first medical care were significantly higher in the elderly patients with ruptured appendicitis (2.18 days) compared to patients with nonruptured appendicitis (1.43 days). Fever and elevated WBC count were not statistically significant (P<.025).

Conclusion : Clinical performance is the most reliable diagnosis of appendicitis in elderly patients, but fever and elevated WBC count are not significant. The presence of ruptured appendicitis is associated with a longer delay before first medical care.

Keywords : Ruptured appendicitis, appendicitis, elderly