Posted on 01/18/2010 2:32:12 PM PST by decimon
DALLAS – Jan. 18, 2010 – Can you catch appendicitis?
And if you do, is it necessarily an emergency that demands immediate surgery?
Yes and no, according to a new study by UT Southwestern Medical Center surgeons and physicians.
The researchers evaluated data over a 36-year period from the National Hospital Discharge Survey and concluded in a paper appearing in the January issue of Archives of Surgery that appendicitis may be caused by undetermined viral infection or infections, said Dr. Edward Livingston, chief of GI/endocrine surgery at UT Southwestern and senior author of the report.
The review of hospital discharge data runs counter to traditional thought, suggesting that appendicitis doesn't necessarily lead to a burst appendix if the organ is not removed quickly, Dr. Livingston said.
"Just as the traditional appendix scar across the abdomen is fast becoming history, thanks to new single-incision surgery techniques that hide a tiny scar in the bellybutton, so too may the conventional wisdom that patients with appendicitis need to be operated on as soon as they enter the hospital," said Dr. Livingston. "Patients still need to be seen quickly by a physician, but emergency surgery is now in question."
Appendicitis is the most common reason for emergency general surgery, leading to some 280,000 appendectomies being performed annually.
Appendicitis was first identified in 1886. Since then, doctors have presumed quick removal of the appendix was a necessity to avoid a subsequent bursting, which can be an emergency. Because removing the appendix solves the problems and is generally safe, removal became the standard medical practice in the early 20th century.
But this latest research studying appendicitis trends from 1970 to 2006 suggests immediate removal may not be necessary. Evidence from sailors at sea without access to immediate surgery and from some children's hospitals, whose practice did not call for emergency surgery, hinted that non-perforated appendicitis may resolve without surgery, said Dr. Livingston.
In undertaking the study, the researchers screened the diagnosis codes for admissions for appendicitis, influenza, rotavirus and enteric infections. They found that seasonal variations and clustering of appendicitis cases support the theory that appendicitis may be a viral disease, like the flu, Dr. Livingston said.
Statistical data revealed peaks, which may be outbreaks of appendicitis, in the years 1977, 1981, 1984, 1987, 1994 and 1998. In addition, researchers uncovered some seasonal trends for appendicitis, documenting a slight increase in appendicitis cases during the summer.
"The peaks and valleys of appendicitis cases generally matched up over time, suggesting it is possible that these disorders share common etiologic determinates, pathogenetic mechanisms or environmental factors that similarly affect their incidence," Dr. Livingston said.
Researchers have been able to rule out flu and several other common infections as a direct cause. They also were able to rule out several types of intestinal viruses.
Appendicitis afflicts about one in 10 people during their lifetime. The condition occurs when the appendix becomes obstructed, but doctors are unsure why. Dr. Livingston and other UT Southwestern researchers in 1995 identified an unexpected rise in appendicitis cases, reversing a downward trend throughout the previous 25 years.
"Though appendicitis is fairly common, it still remains a frustrating medical mystery," Dr. Livingston said. "While we know surgical removal is an effective treatment, we still don't know the purpose of the appendix, nor what causes it to become obstructed."
###
Other UT Southwestern researchers involved in the Archives of Surgery paper were Dr. Robert W. Haley, chief of epidemiology, and Dr. Adam Alder, a resident and lead author. The team also collaborated with economists at Southern Methodist University on novel statistical methodologies to uncover the associations.
Visit www.utsouthwestern.org/surgery to learn more about UT Southwestern's clinical services in surgery, including gastrointestinal and endocrine procedures.
This news release is available on our World Wide Web home page at www.utsouthwestern.edu/home/news/index
To automatically receive news releases from UT Southwestern via e-mail, subscribe at www.utsouthwestern.edu/receivenews
http://www.utsouthwestern.edu/findfac/professional/0,2356,58399,00.html
The hoke's on them.
If memory service yersinia causes appendicitis type symptoms and is associated with handling puppies. I may need to google that later, I’m pulling up some pretty old memories.
It is possible that an appendix without a fecolith could become inflamed by an infectuous agent, causing the lymphoid follicles in the wall of the appendix to swell, resulting in the stasis of feculent matter in the appendix an setting off the same series of events as mentioned above.
In my residency (general surgery) we were taught there was no clinical entity known as chronic appendicitis, however, if a person came in repeatedly with right lower quadrant pain, without the concurring lab fidings (elevated WBC with a left shift) after 3 everts we performed an appendectomy. Most times this resolved the problems.
In third world countries, there is an entity known as tifilitis. It is, in effect, an infestation of round worms (ascaris or vermicularis) in the caecum which results in obstruction of the appediceal lumen, evolving onward to appendicitis.
I have removed several thousand appendix in my practice, but other than appendiceal carcinoma, I don't know a damn thing about the appendix.
I have removed several thousand appendix in my practice, but other than appendiceal carcinoma, I don't know a damn thing about the appendix.
You know you can make a living offing them. ;-)
A quick search shows something about gastroenteritis. But mostly, bubonic and pneumonic plagues.
Yersinia enterocolitica. The infection does clinically mimic appendicitis but I didn’t see the association with handling puppies. I think I heard that in a lecture 20+ years ago, so take it for what it’s worth.
Not to be confused with Yersinia pestis. Otherwise known as the plague.
Different bugaroos? Okay, I misread or saw bad info.
Same family, different species, I could come up with the species when I first posted,
could not come up with
I need an editor.
Ping... (Thanks, neverdem!)
I know someone who had her appendix out at the same time as her sister. They were in adjoining OR’s getting operated on at the same time.
My daughter had chronic appendicitis, which lasted for months. She kept getting sick and having elusive symptoms until it finally localized and became more distinct. Then they were able to diagnose it because the pain got to the point where they did a CAT scan.
It did NOT resolve itself, but got progressively worse. She had the laproscopic surgery and wouldn’t even have spent the night in the hospital except for the fact that the surgery was so late in the day that she didn’t have time to come out of the anesthesia before nighttime.
She was back on her feet and getting around in a couple days. It’s amazing the recovery with that kind of surgery with an appendix that didn’t rupture.
Calling your attention to something we discussed months ago.
Medicine may be finally coming around to common sense facts.
Thanks for the ping!
Thanks for the ping!
Bump.
International Hearings Begin On “Falsified” Swine Flu Pandemic: Greatest Medical Scandal of the Century To Come Under Scrutiny
H1N1 swine flu hoax falls apart at the seams - Novartis uses Cancerous Cells!
It is also one of the main thoroughfares for the immune system.
Swollen lymph nodes is often a sign of infection.
Disclaimer: Opinions posted on Free Republic are those of the individual posters and do not necessarily represent the opinion of Free Republic or its management. All materials posted herein are protected by copyright law and the exemption for fair use of copyrighted works.