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Q&A: Appendicitis and Older Adults

My newspaper recently mentioned a 75-year-old man who died from peritonitis that followed appendicitis. How common is appendicitis in older adults? I thought it was a childhood condition.

Appendicitis is more likely to affect children and adults under age 30, but older adults are not immune from the condition—in fact, studies suggest that 10 percent of appendectomies are performed in people ages 60 and older. In older adults, appendicitis typically causes loss of appetite, nausea, vomiting, abdominal bloating, and constipation. However, the most well-known symptoms—fever, and low abdominal pain that moves toward the right side—often are absent. Because an older adult’s abdomen may be soft and non-painful upon examination, doctors need a high index of suspicion to recognize appendicitis in this age group. This means that the condition often is diagnosed late, when complications are more likely. A perforated appendix is one such complication, and can result in peritonitis (inflammation of the membrane that lines the abdomen). Without swift treatment peritonitis may spread throughout the body, causing a life-threatening infection.

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