Clinical features of acute appendicitis in the elderly
The clinical features of acute appendicitis in the elderly are masked by:
- laxity of the abdominal musculature and hence late or non-development of rigidity
- typically slower presentation of other classical symptoms
- delayed presentation because pain is ascribed by patient to constipation and laxatives are taken instead
- similarity of presentation to intestinal obstruction, which is more common in this age group; enemas prescribed for obstruction may enhance peritonitis
Consequently, elderly patients with acute appendicitis tend to present later in the course of the illness and have a worse prognosis.
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