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News

Distinguishing between acute appendicitis and appendiceal tumors

An article published in November's issue of the American Journal of Surgery suggests that appendiceal tumors should be suspected, as opposed to acute appendicitis, when patients present with longer duration of symptoms or reduced hematocrit.

News image

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Incidence and predictors of appendiceal tumors in elderly males presenting with signs and symptoms of acute appendicitis.

Patients with appendiceal tumors (AT) frequently present with the same signs and symptoms as acute appendicitis (AA).

Dr Todd and colleagues from Virginia, America undertook a study in order to identify the incidence of AT in a population of patients greater than 60 years of age thought to have AA.

The research team also aimed to identify presenting factors that can help differentiate the 2 disease processes.

Duration of symptoms was significantly longer and hematocrit lower for patients with AT compared with patients with AP
American Journal of Surgery

The researchers performed an institutional review board–approved, retrospective review.

The investigators identified all patients greater than 60 years old who underwent either appendectomy or colectomy after presenting with signs and symptoms of AA from January 1997 to April 2004.

The researchers checked patient records for demographic variables, presenting signs and symptoms, and pathology.

In total, 34 patients fit the entry criteria and out of these, the researchers found that 8 (24%) had AT.

The researchers also noted that the average duration of symptoms was significantly longer and hematocrit lower for patients with AT compared with patients with AP.

The research team did not note any other significant differences in presenting signs and symptoms.

There is an increased incidence of appendiceal neoplasms among elderly patients presenting with signs and symptoms of AA.

Dr Todd concluded, "Distinction between AT and appendicitis is difficult preoperatively, but AT should be suspected when patients present with longer duration of symptoms or reduced hematocrit."

American Journal of Surgery; 2004: 188 (5): 500-504
19 November 2004

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