title: Perforated appendicitis in the elderly masquerading as acute coronary syndrome.
abstract: BACKGROUND
  Evaluation of acute appendicitis in the elderly presents a diagnostic challenge to the surgeon. The diagnosis is often difficult to establish on account of general poverty of history and clinical signs, comorbidity and the unreliability of diagnostic procedures. Due to this, morbidity and mortality statistics in this group of patients is unacceptably higher than the general population.
  
  
  METHODS
  Individual case report and literature review.
  
  
  RESULTS
  We present an unusual case of perforated appendicitis masquerading as acute coronary syndrome.
  
  
  CONCLUSIONS
  Patient's education, high index of suspicion, and an aggressive surgical approach is needed if the outcome among the elderly population is to be improved.
authors.affiliation: Department of Surgery, Walsgrave Hospital, Coventry, United Kingdom. eagaba@hotmail.com
authors.forename: Emmanuel Atta
authors.initials: EA
authors.lastname: Agaba
authors.forename: Patrick
authors.initials: P
authors.lastname: Goon
authors.forename: Kamal
authors.initials: K
authors.lastname: Pushdary
authors.forename: Ling S
authors.initials: LS
authors.lastname: Wong
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001062:Appendectomy / Q000009:adverse effects / Q000379:methods; D001064:Appendicitis / Q000175:diagnosis* / Q000601:surgery*; D004562:Electrocardiography; D005500:Follow-Up Studies; D015577:Geriatric Assessment; D006334:Heart Function Tests; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000175:diagnosis*; D011183:Postoperative Complications / Q000175:diagnosis / Q000628:therapy; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome