Appendicitis in Elderly - Not a Usual Form of Appendicitis

Acute appendicitis tends to have a more complicated course in advanced age, being associated with higher risk of complications. In the elderly population, however, the presentation may be atypical and cause a diagnostic delay, this can be explained by physiological changes in the elderly, such as decreased immune response, bowel function and pain perception. A misdiagnosis occurs in about half of the patients and almost 25 % of the patients requires more than 24 hours to receive the correct diagnosis, increasing the risk for perforation which rises to 70 % in these subjects. The acute appendicitis must be considered in the differential diagnosis evaluation for abdominal pain in elderly, in order to reduce morbidity and mortality.