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 that appendicitis may be caused by an undetermined viral infection or infections, said Dr. Edward Livingston, senior author of the report.
The review of hospital discharge data, which appears in the January issue of Archives of Surgery, runs counter to traditional thought, suggesting that appendicitis doesn’t necessarily lead to a burst appendix if the organ is not removed quickly, Livingston, chief of GI/endocrine surgery at UT Southwestern, said in a statement.
"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 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 problem 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 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, Livingston said.
Appendicitis afflicts about one in 10 people during their lifetime. The condition occurs when the appendix becomes obstructed, but doctors are unsure why.
“Though appendicitis is fairly common, it still remains a frustrating medical mystery,” 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.”
According to WebMD, symptoms of appendicitis include:
• Abdominal pain. Pain is the main symptom of appendicitis. At first it is usually generalized in the central part of the abdomen around the belly button. As the condition progresses, the pain becomes localized, generally to the lower right quadrant—a small area between the navel and the front of the right hip bone. The pain doesn't go away and is worse when you cough, move, or walk.
• Constipation, back ache, slight fever, or a swollen abdomen
• Loss of appetite. Loss of appetite can progress to nausea and even vomiting.