Reports in the literature had appeared describing the advantages of laparoscopic surgery over the open technique in terms of decreasing post operative pain, time to recovery, wound complications and post operative hospital stay, while LY411575 research buy others found that referring an elderly patient with complicated appendicitis to laparoscopic surgery see more will increase the operative time, conversion rate and length of hospital stay [19, 31, 33]. In a recent study published in 2013, Wray CJ et al. concluded that, the question of whether or not appendectomy should be performed via an open or laparoscopic technique has been inherently difficult to answer because both approaches offer similar

advantages, namely, a small incision, low incidence of complications, a short hospital stay, and rapid return to normal activity [25]. At our hospitals, the laparoscopic approach has been adopted for the treatment of appendicitis in the younger age groups but so far, not for the elderly patients. Despite the fact that appendectomy has been regarded as the standard treatment for appendicitis for more than

100 years, several reports have appeared in the literature over the last few years describing nonoperative management of acute, uncomplicated appendicitis. This conservative treatment which consists of nil by mouth, intravenous fluids and broad spectrum antibiotics had proved effective with less pain but had high recurrence rate, a risk that should Torin 2 be

compared with the complications after appendectomy [27, 34–38]. However, Wray CJ et al. considered that the available evidence regarding this nonoperative management is provocative and that level 1 data to suggest this is an alternative treatment option are not universally accepted [25]. Although the main object of our study was not the management of acute appendicitis in elderly patients, but after reviewing the literature, we think that the non operative management of acute appendicitis in this age group should be comprehensively studied. The result of this study should be read with limitations. First, it is a retrospective study and in order to highlight the risk factors leading to appendiceal perforation one would ideally Etofibrate collect clinical data before and not after perforation occurred. Second, the rate of perforation differs according to the patient’s accessibility to medical health services. Conclusion Acute appendicitis should still be considered in the differential diagnosis of abdominal pain in the elderly patients. Delay in presentation to the hospital is associated with higher rates of perforation and post operative complications. All elderly patients presented with abdominal pain should be admitted and investigated. The early use of CT scan can cut short the way to the appropriate treatment.