Surgery>>>>>Surgical Considerations in the Elderly
Question 5#

Elderly patients with acute peritonitis may NOT present with typical symptoms of acute abdominal pain, fever, or leukocytosis due to an impaired immune response. A high index of suspicion is needed as the initial clinical diagnosis in elderly patients with acute appendicitis is correct in what percent of cases?

a. Less than 50%
b. 70-80%
c. 90-95%
d. 100%

Correct Answer is A


In elderly patients with acute appendicitis or acute cholecystitis, one-third lack symptoms of abdominal pain, one-third are afebrile, and one-third have a normal white blood cell count. Therefore an "unimpressive" abdominal examination is irrelevant in the evaluation of the elderly patient whose tolerance for food has suddenly changed.