[Acute appendicitis in advanced age].

In the elderly, both the diagnosis and treatment of acute appendicitis require particular attention. The diagnosis is often made very late with 40% to 80% of the cases already having perforated. Reasons for the delayed hospitalisation include atypical course, reduction in sensitivity to pain in old age, and an inadequate ability to communicate. The prognosis of uncomplicated appendicitis is just as good in the old as in the young patient, but perforation and concomitant diseases worsen the situation appreciably. Early operation is therefore desirable. The preference of the author is for open, rather than laparoscopic, appendectomy.