Appendicitis

Appendicitis, sometimes known as epityphlitis, is a condition whereby people suffer from an inflammation of the appendix. Some milder cases can resolve themselves using the body's natural functions, but most require the removal of the inflamed appendix either by laparotomy or laparoscopy, often leaving a small scar. Essentially, if untreated, the risk of peritonitis, when the inflamed appendix bursts, and shock, is high and death can result.

The first person to describe acute appendicitis was Reginald H. Fitz in 1886. His article, “Perforating Inflammation of the Vermiform Appendix with Special Reference to Its Early Diagnosis and Treatment,” was published in the American Journal of Medical Science and led to the recognition that appendicitis is one of the most common causes of trouble in the abdomen for humans around the world.

There are a range of causes for appendicitis, which may come from a hard mass of fecal matter, with many people suggesting the swallowing of grape seeds or similar materials might cause this, from viral induced ulcers, and/or lymphoid hyperplasia. Excessive consumption of alcohol may also exacerbate a case of appendicitis. Doctors try to establish whether a patient may have appendicitis by measuring the number of white blood cells (leukocytes), which often increase from the normal count of between 5,000 and 10,000 (for an adult) to an abnormal count of between 12,000 and 20,000. This takes place because of other acute inflammatory conditions that occur in the abdomen at the same time.

Those suffering an attack of appendicitis usually feel pain all over their abdomen or sometimes in their upper abdomen around the area of the navel. The pain is usually not that severe, and for a period of one to six hours after the first pain sensation, the abdominal pain becomes restricted to the lower right side. There may also be nausea and/or vomiting, with patients often developing a fever, although this sometimes happens some hours, or even a day, later.

The basic method for treating appendicitis is for a surgeon to completely remove the appendix in a minor operation, regularly performed, called an appendectomy. For this reason, many people have their appendix removed ahead of any trouble. The operation itself, conducted under anesthesia, may be over in as little as 30 minutes. Problems arise if the diagnosis of acute appendicitis is not made straightaway; it is possible for doctors to wait for a while—often as long as 34 hours—so that a more definitive diagnosis can be made. During that time, it is important for the patient to remain in the hospital in case of medical emergencies and/or when the need for surgical intervention arises.

Owing to the complications of acute appendicitis and the fact that appendectomy can be performed without side effects, some people planning travels or expeditions, or moving to countries where medical care is not good, may opt for an appendectomy before they leave. In 1950 a crisis arose when Dr. Serge Udovikov needed an appendectomy in the Australian Antarctic Territory. Now, in remote places such as the Mawson Base in the Australian Antarctic Territory (where a case happens on average every two years), it is considered necessary to have a resident doctor capable of performing an appendectomy.

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