[Acute appendicitis: a serious disease in the elderly].

OBJECTIVE: To determine the differences between acute appendicitis in younger and in older patients. DESIGN: Retrospective study. SETTING: Utrecht University Hospital and Diakonessen Hospital Utrecht, the Netherlands. METHOD: All patients operated in the period 1989-1991 because acute appendicitis was suspected were included in this study. The patients were divided into two groups, one fifty years of age or older, one younger. Duration of symptoms, histology, closure or non-closure of the incision, complications and hospital stay were examined. RESULTS: About ten percent of the patients were over fifty years of age (35/366). The duration of symptoms in this group was significantly longer. Appendix sana occurred less often in the elderly, perforated appendix more often. The wound was left open more often in the elderly, but they did not have more complications. Their hospital stay, however, was significantly longer. CONCLUSION: The longer duration of symptoms and the higher rate of perforation justify a higher place of acute appendicitis in the differential diagnosis of acute abdomen in the elderly. The more serious course of the disease appears from the longer hospital stay.