CLINICAL AND PARACLINICAL CHARACTERISTICS IN ELDERLY PATIENTS WITH APPENDICITIS PERITONITIS AT THONG NHAT HOSPITAL

Abstract

Appendiceal peritonitis is a common surgical emergency, particularly dangerous in the elderly due to atypical symptoms and high risk of complications. However, studies on the clinical and paraclinical characteristics of this condition in this age group in Vietnam remain limited. To describe the clinical and paraclinical features of appendiceal peritonitis in elderly patients at Thong Nhat Hospital, while analyzing risk factors associated with complications and hospital stay duration. A retrospective cross-sectional descriptive study was conducted on 39 patients aged ≥60 diagnosed with appendiceal peritonitis and undergoing surgery at Thong Nhat Hospital from October 2023 to October 2024. The mean age of patients was 71.9, with a nearly equal male/female ratio (48.7%/51.3%). Right lower quadrant pain was the most common symptom (48.7%), but only 20.5% of patients had mild fever. Leukocytosis (≥10 G/L) was observed in 74.4% of cases, and CRP ≥10 mg/L in 41%. CT scans detected infiltration in 76.9% of patients. Comorbidities such as hypertension (38.5%) and diabetes (20.5%) increased the risk of complications and prolonged hospital stays. The age group ≥70 had a higher rate of appendiceal necrosis (66.7%) compared to the 60–69 age group (38.1%). Appendiceal peritonitis in the elderly presents with atypical clinical features, often leading to delayed diagnosis. Comorbidities and advanced age are significant risk factors for severe complications. Imaging plays a crucial role in early detection and disease severity assessment.