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Forum Name: Colon and Rectal Cancers

Question: Does appendicitis over age 50 indicate colon cancer


 Ruthiejb - Thu Sep 18, 2008 8:25 pm

My 51-year old husband had emergency surgery for a ruptured appendix 3 weeks ago. His body had formed an abscess so he didn't have peritonitis. He's doing well and back to work. However, when he had his stitches removed, the surgeon told us that the inflammation came from outside the appendix which is atypical. He suggested that my husband consult with a gastroenterologist. In doing research, I found that appendicitis over the age of 40 has been associated with colon cancer. Is this correct? My husband has a colonoscopy scheduled for next month, but I'm very nervous about this. What else may have caused the inflammation from outside the appendix? A contrast CT scan was used to diagnose the appendicitis....would that have shown any sign of colon cancer?Thank you.
 Dr. Safaa Mahmoud - Thu Oct 09, 2008 10:14 am

User avatar Hello,

It is true that about 3% of patients over the age of 40 with appendicitis may have an underlying colonic cancer. In fact right sided tumors may cause obstruction of the lumen of the appendix resulting in appendicitis and right iliac fossa abscess although rare. Left sided colonic tumors may also present with appendicitis.

Thus, it is important to search for an underlying colonic cancer in elderly patients presenting with appendicitis.

CT imaging is not enough and colonoscopy and biopsy are essential for all patients to exclude malignancy. This is usually done within few (6) weeks from appendicectomy when the patient recovers.
Other causes include fecalith (hard feces), lymphoid hyperplasia and parasites.

So, I advise you to follow up with his doctor.
Please keep us updated.
Best regards.

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