[Appendicitis in the elderly: delay between the first symptoms and surgical procedure]. / Apendicitis en el anciano. Retraso desde el inicio de los síntomas hasta la cirugía.

Acute appendicitis is the most frequent etiology of abdominal laparotomy, and although it's thought that is a pathology of young patients, not only it isn't infrequent in elderly patients but it's increasing its incidence in the last decades, in part due to longer expectative of life in the general population. We studied the particularity of presentation and evolution in a group of 73 patients older than 60-year old, in comparason with a younger group. The clinical findings were typical in the most of patients, unrelated to the age, but problems as: delay in the clinical assistance, to have associated another diseases, and delayed diagnosis and operation, make the appendicitis in the older patient to have an increased incidence of complications. Moreover, post-operative complications occurred much more frequently, specially at the surgical incision, with a higher morbidity and hospital stay.

Esophageal inflammatory fibroid polyp. Endoscopic and radiologic features.

We present the case of a 60-year-old male patient, who had several episodes of melena during the last years. One month ago he had a new episode of digestive bleeding, and an endoscopic study was performed that showed at 35 cm from the dental arcade a polypoid, pedunculated lesion, with a diameter of 5 cm and a submucosal aspect, a few erosions on its surface and a fibrin deposit. Its head reached the cardia, and it bled when touched by the endoscope. The biopsies taken were negative. X-ray and CT studies confirmed the existence of a mass compatible with a submucosal lesion. The patient was operated and the tumor was excised. The histologic study showed an inflammatory fibroid polyp, an entity very rarely described at the level of the stomach, duodenum, small intestine, and colon and exceptionally described at the esophageal level.