History of Appendicitis

The first descriptions of the appendix date to the sixteenth centuryAlthough first sketched in the anatomic notebooks of Leonardo da Vinci around 1500, the appendix was not formally described until 1524 by da Capri and 1543 by Vesalius.Perhaps the first description of a case of appendicitis was by Fernel in 1554, in which a 7-year-old girl with diarrhea was treated with a large quince. Soon thereafter she developed severe abdominal pain and died. Autopsy showed that the quince had obstructed the appendiceal lumen, resulting in appendiceal necrosis and perforation. For the next few centuries, such cases of appendicitis were typically diagnosed at autopsy. Amyand is credited with the first appendectomy in 1736, when he operated on a boy with an enterocutaneous fistula within an inguinal hernia.On exploration of the hernia sac, he discovered the appendix, which had been perforated by a pin resulting in a fecal fistula. As a result of his original description, an inguinal hernia containing the appendix carries Amyand’s eponym to this day.Nearly 150 years passed until Lawson Tait in London presented the first successful transabdominal appendectomy for gangrenous appendix in 1880. Less than a decade later, in 1886, Reginald Fitz of Harvard Medical School first described the natural history of the inflamed appendix, coining the term “appendicitis.”In 1889, Charles McBurney of the Columbia College of Physicians and Surgeons in New York presented his series of cases of surgically-treated appendicitis and in so doing described the anatomic landmark that now bears his name. McBurney’s point is the location of maximal tenderness “very exactly between an inch and a half and two inches from the anterior spinous process of the ileum on a straight line drawn from that process to the umbilicus.”In the 1890s, Sir Frederick Treves of London Hospital advocated conservative management of acute appendicitis followed by appendectomy after the infection had subsided; unfortunately, his youngest daughter developed perforated appendicitis and died from such treatment. Numerous advances in the diagnosis and treatment of appendicitis have emerged in the past 125 years. Nonetheless, acute appendicitis continues to challenge surgeons to this day.

How to Detect Acute Appendicitis

Acute appendicitis is the most common cause of abdominal pain among children and teenagers worldwide. They can be either acute or chronic. Acute appendicitis develops fast and can be removed using surgery. It can become severe, however, if not discovered and treated in time. Chronic appendicitis, on the other hand, develops slower and has less pronounced symptoms. Acute appendicitis is caused by bacterial infections in the vermiform appendix, a tubular extension of the large intestine which functions as part of the digestive process. When the appendix is blocked by feces or it is squeezed by lymph nodes, it swells and usually doesn’t receive enough blood. When this happens, bacteria invade and grow inside the appendix, eventually causing its death. Acute appendicitis is serious and can lead to complications like perforation, gangrene and sepsis. A surgical emergency is the only way to remove it but what usually happens is that most patients already have complications before they enter the operating room. Symptoms of acute appendicitis are intense, continuous abdominal pains, which first occur in the umbilical region and later locate in the right lower region of the abdomen. Other symptoms include poor appetite, nausea, vomiting, constipation or diarrhea, and fever. Although unspecific in character, the symptoms, if they occur often enough, can indicate the presence of the illness. It is often hard to diagnose appendicitis in young children, the elderly, and women of childbearing age. In kids two years old or younger, the symptoms are vomiting, a bloated or swollen abdomen and pain. In most cases, true appendicitis is often misdiagnosed as gastroenteritis, an inflammation of the stomach and intestines. It is not uncommon, however, for patients to have only one symptom or without symptoms at all, which complicates the process of correctly diagnosing the illness. The only effective means of discovering acute appendicitis are abdominal computerized tomography, blood analysis and a detailed physical examination. Surgery remains the first option in the treatment of acute appendicitis. Though a doctor may prescribe treatment with antibiotics to deal with the inflammation and bacterial infection of the appendix, the obstruction can only be corrected through surgical intervention. Called an appendectomy, surgery is the best way to contain the illness and to prevent its recurrence and the development of complications. Other cures also include using home-made remedies, which is applicable if the appendicitis is caught in its earliest stages and before a rupture occurs. Some of these remedies include fasting, bed rest, applying hot compresses to the painful area several times a day to relieve cramping and inflammation, using an enema daily to help cleanse the lower bowels, and drinking fresh, natural fruit and vegetable juices. If treated in time, patients suffering from acute appendicitis recover quickly and without effort. Full recover is usually within four weeks from surgery. In the case of complicated acute appendicitis, patients require special monitoring before and long after the surgical treatment. If undetected and not prevented in time, acute appendicitis is life-threatening with the rate of mortality considerably high.