ACUTE APPENDICITIS IN PATIENTS OVER 70 YE ARS OF AGE

Objectives: We assessed preoperative diagnosis of appendicitis and per forations in elderly patients in our unit to determine whether the ove rall higher rate of appendectomy in France (3 to 4 times higher than i n anglo-saxon countries) has an effect. Methods: We analyzed retrospec tively the cases of all patients over 70 years of age who underwent ap pendectomy for histologically confirmed appendicitis between February 1, 1990 and 31 January 1995, Results: There were 20 patients (15 women 5 men) in the study group (age range 70-89 years), The site of abdomi nal pain was atypical in 10 cases (50%) and acute bowel occlusion occu rred in 9 (45%). The diagnosis of appendicitis was made before surgery in 10 patients; surgery was performed within 24 hours of admission in only 8. The high rate of perforations (70%) was not correlated with a ge. Complications occurred in 70% of the cases and were related to per foration (p < 0.02) and an American Society of Anesthesia (ASA) score > 2 (p < 0.05),Conclusion: Acute appendicitis in the elderly patient i s a serious condition, The atypical nature of the clinical presentatio n in half of the patients often requires computed tomography or laparo scopy for diagnosis.