ACUTE APPENDICITIS IN ELDERLY PATIENTS- CHALLENGES IN DIAGNOSIS AND MANAGEMENT
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 32
Abstract
BACKGROUND Acute appendicitis in elderly patients presents with delayed and atypical presentations and it leads to increased frequency of perforation and intra-abdominal infections requiring prompt diagnosis and surgical intervention. MATERIALS AND METHODS The cross-sectional study was conducted on patients with diagnosis of acute appendicitis aged 60 years and above, admitted in the surgical wards of Department of Surgery, RIMS, Imphal. The study was conducted for a period of 2 years from September 2014 to September 2016. RESULTS Majority of the patients were from the age group 60 - 70 years (66.7%). Males were more than females (55.6% vs. 44.4%). More than half of the patients were from urban areas (55.6%) and majority were from middle class families (88.8%). All the patients in the study presented with pain abdomen, 10 patients (18.5%) with typical pain abdomen and 44 patients (81.4%) with atypical pain abdomen. In 18 cases (33.3%), there was history of anorexia and 18 cases (33.3%) gave a history of vomiting with varying frequency. Fever was present in 30 cases (55.6%). 2 patients (3.7%) had diarrhoea and 25 (46.2%) gave history of constipation. Majority of the patients (81.4%) were diagnosed as acute appendicitis, 11.1% as appendicular abscess and appendicular perforation in 7.4% of cases. Appendicectomy was performed in 29 patients (53.7%), laparotomy was performed in 1 case (1.8%), where there was generalised peritonitis and incision and drainage done in 6 cases (11.1%) and non-operative treatment considered in 18 patients (33.3%). CONCLUSION Acute appendicitis is a common surgical emergency and is a frequently suspected differential diagnosis presenting with acute abdominal pain. Majority of the patients usually present late, commoner in male sex, lives in urban areas. Most of the patients had atypical presentation with only 18.5% having typical presentation. Resuscitation plays a key role, while monitoring an elderly patient with acute abdomen before a clinical diagnosis is made. Presence of any co-morbid condition, which is a common finding in elderly increases the morbidity and mortality
Authors and Affiliations
Sunilkumar Singh Salam, Laitonjam Chinglensana, Vanlalremsiama Vanlalremsiama, Yumnam Priyabarta, Manoharmayum Birkumar Sharma
Keywords
Related Articles
- EP ID EP541161
- DOI 10.14260/jemds/2018/805
- Views 101
- Downloads 0
ISOLATED UMBILICAL ARTERY DOPPLER VELOCIMETRY IN INTRAUTERINE GROWTH RESTRICTED FOETUSES WITH CORRELATION OF FOETAL OUTCOME
BACKGROUND Intrauterine Growth Restriction (IUGR) is the condition of a foetus whose size or growth is subnormal and defined on the basis of foetal weight below 10th percentile for corresponding gestational age. The pres...
A CROSS-SECTIONAL STUDY ON VARIOUS ASPECTS ASSOCIATED WITH ATTENTION DEFICIT HYPERACTIVITY DISORDERS IN INDORE DISTRICT (MADHYA PRADESH)
BACKGROUND Attention deficit hyperactivity disorder is the most common neurobehavioral disorder in children estimated to affect 5% - 10% of school-aged children, particularly boys. Aims and Objectives1) To study various...
A DESCRIPTIVE STUDY OF THE EMERGENCY LAPAROTOMIES AT A GOVERNMENT TEACHING HOSPITAL
BACKGROUND Although, emergency laparotomy is a common surgical procedure performed routinely, yet outcome data and postoperative care data is very less documented. Therefore, we undertook this systematic study of emergen...
A COMPARATIVE STUDY OF RISK FACTORS OF CARDIOVASCULAR DISEASES IN YOUNG ADULTS WITH FAMILY HISTORY OF HYPERTENSION/DIABETES MELLITUS
BACKGROUND Non-communicable chronic diseases viz. diabetes mellitus, obesity, hypertension, cardiovascular diseases are assuming importance among the adult population in both developed and developing countries. Hypertens...
A COMPARATIVE STUDY ON SAFETY AND EFFICACY OF MIDAZOLAM BY INTRANASAL AND INTRAVENOUS ROUTE FOR PAEDIATRIC PROCEDURAL SEDATION
BACKGROUND Pain perception in young children did not receive much attention as there are concerns regarding the safety of administering potent opiates and sedatives. Moreover, we often consider that it is natural for chi...