A Brief History of Appendicitis: Familiar Names and Interesting Patients

Cj, Streck; th, Maxwell Pj

doi:10.1177/000313481408000216

Cited by 4 publications

(5 citation statements)

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“…1 In 1731, the first recorded appendectomy was performed by English surgeon William Cookesley, shortly followed by French surgeon Claudius Amyand in 1735. Little progress had been made on the disease until 1886, when American pathologist Reginald Fitz described a series of 25 patients with perforating inflammation of the appendix, which he termed “appendicitis.” 1 His work changed the understanding of the disease and advocated for early treatment of what was an invariably fatal diagnosis in the pre-antibiotic era. Surgery for appendicitis would become more common in both the United States and Europe in the late 1880s-1890s.…”

Section: Main Bodymentioning

confidence: 99%

“…Anatomists Andreas Vesalius and Gabriel Fallopius provided early descriptions of the human appendix in the mid-1500s, and later, in 1709, Herman Boerhaave treated “iliac passion” with warm enemas, bloodletting, and abdominal compresses. 1 In 1731, the first recorded appendectomy was performed by English surgeon William Cookesley, shortly followed by French surgeon Claudius Amyand in 1735. Little progress had been made on the disease until 1886, when American pathologist Reginald Fitz described a series of 25 patients with perforating inflammation of the appendix, which he termed “appendicitis.” 1 His work changed the understanding of the disease and advocated for early treatment of what was an invariably fatal diagnosis in the pre-antibiotic era.…”

Section: Main Bodymentioning

confidence: 99%

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From the Base of the Cecum to the Throne of England: King Edward VII’s Appendix

Lovasik

Dodson

Srinivasan

2022

The American Surgeon™

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This historical retrospective explores the case of King Edward VII’s appendicitis at the time of his planned coronation in 1902, as well as the contributions of the king’s surgeons Frederick Treves and Joseph Lister, towards his medical care. The history of appendicitis, as well as a view of the king’s medical management in the lens of modern surgical and sociopolitical contexts, is also examined.

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Section: Main Bodymentioning

confidence: 99%

Section: Main Bodymentioning

confidence: 99%

From the Base of the Cecum to the Throne of England: King Edward VII’s Appendix

Lovasik

Dodson

Srinivasan

2022

The American Surgeon™

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“…From ancient Egyptian (3100BC-332BC), Greco-Roman (800BC-600AD), medieval (500 to 1400-1500 CE), European renaissance (1400-1700 CE) times and contemporary times, acute appendicitis has remained a major concern for physicians, especially the general surgeon. [1][2][3][4]. Over these times, there has been a steady evolution in the diagnosis and treatment of the disease that has been directed at improving disease outcomes.…”

Section: Introductionmentioning

confidence: 99%

Clinical, Radiological and Pathological Appraisal of Acute Appendicitis in Al Qassim, Saudi Arabia: A Single-Center Retrospective Analysis

Alnuaymah¹,

Etonyeaku²,

Alsaeed³

et al. 2022

Cureus

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BackgroundAcute appendicitis can occur at any age but is rare among people of extreme age; it is more common in teenagers and young adults. Traditionally diagnosis is made on clinical grounds. In recent times imaging techniques have been deployed to improve diagnosis and reduce negative appendicectomy rates. The aim of the study was to describe the common clinical features of acute appendicitis among our patients, highlight the role of medical imaging, and compare all these with the histological report of the excised appendix. MethodsA 24-months retrospective review of all patients who underwent appendicectomy (July 1, 2019-June 30, 2021) for suspected acute appendicitis was performed. Medical records numbers of patients who had appendicectomies were retrieved from the operating room register. These numbers were used to access the hospital's electronic medical records database for the patients' records. These records were reviewed for biodata, clinical features, laboratory, medical imaging findings, and histological reports. ResultIn this hospital, 354 appendicectomies were performed. Only 336 had complete data set suitable for further review. There were more males (N=257; 76.5%) than females (N=79, 23.5%), yielding a male to female ratio of 4:1. There were also more Saudi citizens (n=266, 79.2%), with the predominant age group being 11-30 years. Abdominal pain was the predominant symptom (100%) and was localized to the right iliac region in 331 (98.7%) of patients. Other symptoms recorded were anorexia (n=247, 73.5%), vomiting (n=190, 56.5%), and nausea (n=93, 27.7%). Atypical symptoms included diarrhoea (n=27, 8%) and constipation (n=12, 3.6%). Acute appendicitis, complicated appendicitis, and no appendicitis were the reported histological disposition in 174 (51.8%), 124 (36.9%), and 38 (11.3%) cases respectively. Abdominal CT scan had a higher sensitivity (98.6% vs 70.5%), higher diagnostic odd ratio (2.5 vs 1.4) and a lower miss (false negative) rate (1.4% vs 29.5%) compared to ultrasonography. However, the CT scan, from this study, has a rather low specificity (3.4%) and high false positive rates (96.5%). Open (n=205; 61%) and laparoscopic (n=131;39%) approaches were used for the appendicectomies. In our study, 44 patients were diagnosed with the decision to operate based on clinical grounds; and of this, 42 (95.4%; n=44) had confirmatory histology reports of appendicitis. Also, 38 patients had negative appendicectomy; giving a negative appendicectomy rate of 11.3%. This high rate may be due to the lower specificity and high false positive rate observed in this study. The postoperative complication rate was 21.4%, and this was solely due to surgical site infection, and this was more common with the open approach (p=0.001). ConclusionSuspected acute appendicitis was the sole indication for our appendicectomies. A computerized tomography scan was a more reliable diagnostic tool than ultrasonography. Despite the fact that acute appendicitis is majorly a clinical diagnosis, and good clinical acumen is an excelle...

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“…T HE HISTORY OF the appendix dates back into the time of the Egyptians, but no published documentation existed until a drawing by Leonardo da Vinci in 1492 (not published until the 18th century) and the first description by Berengario Da Carpi in 1522. 1 Since that description, appendicitis remained a diagnosis that was most commonly found after an autopsy was performed and it was not until the article by Dr. Fitz in 1886 that it was accepted that acute appendicitis should undergo surgical intervention. 2 Claudius Amyand performed the first appendectomy through a scrotal incision due to a hernia in 1735, but it was not until after Dr. Fitz's article that the first deliberate operation for appendicitis was performed by Dr. Morton in 1887, several reported cases of appendectomies were reported in the interval, but still great debate remained on whether the appendix was the source of the illness and who should be credited for the first appendectomy.…”

mentioning

confidence: 99%

“…14 Early literature regarding treatment of appendicitis focused on incision and drainage of an abscess in the right lower quadrant, which occurred after perforation, and then gradually surgeons started to perform laparotomies and then appendectomies. 1,3,4 In addition, because this was considered to be related to constipation or fecal impaction, some physicians attempted to treat acute appendicitis with laxatives and stimulants rather than an early operation. 15 Since Fitz's presentation, early appendectomy has become the gold standard of care, but there has existed some ambiguity in the treatment of patients who presented late in their course.…”

mentioning

confidence: 99%

Factors Associated with Failure of Nonoperative Management for Complicated Appendicitis

Walker

Moosavi

Young

et al. 2019

The American Surgeon

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In recent years, nonoperative management of complicated appendicitis has become more common. Patients managed nonoperatively do well, but there is a paucity of literature on patients who fail nonoperative management. The purpose of this study was to examine the overall failure rate, morbidity associated with failure, and potential predictors of failure in nonop management of appendicitis. This is a descriptive retrospective review of patients from a single hospital system who were diagnosed with advanced appendicitis and underwent nonop management between January 1, 2007, and November of 2017. The data were obtained through review of patient charts from the electronic medical record. Failure was defined as requirement of an operation due to ongoing infection secondary to appendicitis. There were 183 patients initially managed non-operatively, with 70 patients failing nonoperative management. Patients failing nonoperative management experienced longer hospitalization (6.2 vs 2.9 days, P < 0.0001), and more patients in the failure group required admission to the ICU (10.0% vs 1.8%, P = 0.028). Multivariate analysis revealed that longer duration of symptoms reduced the likelihood of failure (odds ratio: 0.77 [0.64–0.92]). In this retrospective review, 38 per cent of patients failed nonop management of appendicitis. Symptom duration could provide insight for clinicians in assessing the role of non-operative management because increasing symptom duration reduced the likelihood of failure.

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A Brief History of Appendicitis: Familiar Names and Interesting Patients

Cited by 4 publications

References 1 publication

From the Base of the Cecum to the Throne of England: King Edward VII’s Appendix

From the Base of the Cecum to the Throne of England: King Edward VII’s Appendix

Clinical, Radiological and Pathological Appraisal of Acute Appendicitis in Al Qassim, Saudi Arabia: A Single-Center Retrospective Analysis

Factors Associated with Failure of Nonoperative Management for Complicated Appendicitis

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