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노인에서 발생한 급성 충수염의 임상적 분석

Clinical Analysis of Acute Appendicitis in the Elderly

대한대장항문학회지 2002년 18권 5호 p.274 ~ 280
안상수 ( Ahn Sang-Soo ) - 서울시립동부병원 외과

소윤섭 ( So Yoon-Sub ) - 서울시립동부병원 외과
조익행 ( Jo Ik-Haeng ) - 서울시립동부병원 외과
백현명 ( Baek Hyun-Myung ) - 서울시립동부병원 외과
이성열 ( Lee Sung-Yul ) - 서울시립동부병원 외과

Abstract


Purpose: Surgeons are confronted frequently with the diagnostic and therapeutic challenges in the cases of acute appendicitis in the elderly. Despite the improvements in management, the morbidity and mortality remain high. In order to
verify contributing factors of high morbidity and mortality and establish more proper diagnostic and therapeutic strategies, we compared the clinical characteristics and outcomes of acute appendicitis in the elderly with those of younger people.

Methods: We retrospectively reviewed medical records of 30 elderly and 248 younger people who were pathologically diagnosed as appendicitis after an appendectomy.

Results: There was no difference in the rates of occurrence of right lower abdominal pain and tenderness between the two people. The rate of appendiceal perforation was significantly higher in the elderly. Prehospital delay was
significantly longer in the elderly. Concomitant diseases were more prevalent in the elderly. The hospital stay was significantly longer and the rate of complication was relatively higher in the elderly also.

Conclusions: When a vague and unexplained abdominal discomfort occurs in the elderly, we should suspect and rule out acute appendicitis as the cause of the discomfort. Early aggressive diagnostic and therapeutic interventions are essential components in managing acute appendicitis in the elderly. In addition, perioperative evaluation and prophylactic measures for concomitant diseases are needed to decrease morbidity and mortality in the elderly.

키워드

급성 충수염;노인;급성 복증
Acute appendicitis;Elderly;Acute abdomen
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