Hashim Thamir, AlTahan Yara A, Elgassim Moayad A, Zaki Hany A, Elgassim Mohamed, Abdelrahman Amro
Emergency Medicine, Hamad Medical Corporation, Doha, QAT.
Community Medicine, Hamad Medical Corporation, Doha, QAT.
Cureus. 2024 Jul 29;16(7):e65622. doi: 10.7759/cureus.65622. eCollection 2024 Jul.
Acute appendicitis in elderly individuals is uncommon and poses a significant challenge due to atypical symptomatology. An 85-year-old male presented to the emergency department (ED) with abdominal pain associated with nausea and reduced oral intake. Physical examination revealed diffuse abdominal tenderness. He was initially treated for constipation with an enema and discharged. Two days later, the patient returned with worsened pain and a new onset of fever. Examination revealed guarding. Lab results showed significant elevation in C-reactive protein (CRP) and white blood count (WBC). A contrast-enhanced computed tomography (CT) scan showed evidence of a perforated appendix. He was admitted into the surgical ward and improved on conservative treatment. This case describes an atypical presentation of acute appendicitis in an elderly patient, emphasizing the importance of recognizing unusual presentations in this population. Early use of contrast-enhanced CT scans is crucial for accurate diagnosis and improving patients outcomes.
老年急性阑尾炎并不常见，由于症状不典型，给诊断带来了重大挑战。一名85岁男性因腹痛伴恶心、进食减少到急诊科就诊。体格检查发现全腹压痛。他最初接受灌肠治疗便秘后出院。两天后，患者因疼痛加重和新出现发热再次就诊。检查发现有肌紧张。实验室检查结果显示C反应蛋白（CRP）和白细胞计数（WBC）显著升高。增强计算机断层扫描（CT）显示阑尾穿孔。他被收入外科病房，经保守治疗后病情好转。本病例描述了老年患者急性阑尾炎的非典型表现，强调了认识该人群异常表现的重要性。早期使用增强CT扫描对于准确诊断和改善患者预后至关重要。
