Acute Appendicitis in Elderly Clinical Trial
Official title:
Senior House Officer of Trauma and Emergency Surgery
Aims of this study are :
- Estimate the incidence of A.A. in patients above age of 30 y in 4 age groups .
- Correlate between different clinical aspects and histopathological results.
- Determine rate of negative appendectomy in those patients.
Acute appendicitisis the clinical condition which refer to inflammation of the vermiform
appendix1. It is the most common abdominal emergency2,3,4 .it accounts for more than 40,000
hospital admissions in England every year 5 . Approximately 8% of the population in Western
countries would have appendicitis during their life 6 .In the United States, the estimated
incidenc of acute appendicitis is 11 cases per 10,000 population 5 . However, in South
Africa, the incidencewas estimated to be less than 9 per 100,000 6 .Appendectomy is
considered the most common emergency surgical procedure worldwide6,8 ,9. The cause of acute
appendicitis is unknown but it is multifactorial; luminal obstruction , dietary and familial
factors have been suggested 5 . Fecoliths are the most common cause of obstruction. It was
demonstrated that the mean duration of abdominal pain in patients with gangrenous appendix is
46.2 hours and 70.9 hs for perforated 7 .
The peak incidence of acute appendicitis is at the age of 10 to 30 years 6,10. There are
special features for appendicitis according to age 1. A.A is primarily a disease of the
younger population, with only 5-10% of cases occurring in elderly people, but the incidence
of acute appendicitis in elderly began to increase with the increase in life expectancy14.
Older patients with acute abdominal pain are high-risk patients, unlike their younger
counterparts15 . Morbidity and mortality rates are greater in elderly due to atypical
presentations and delay in diagnosis leading to increase rate of perforation and
intra-abdominal infection.. They need to be clinically evaluated by experienced surgeons
within a narrow time margin14,15.
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