YOUR HEALTH - MEDICINE 101

APPENDICITIS
The word appendix comes from the Latin root APPENDERE, meaning to be attached or to hang. It’s the same root as the word appendage. The appendix is a small tubular-shaped sac attached to the beginning of the large bowel – here. The proper medical term is the vermiform or worm-like appendix. It can be as long as 25 cm but the average length is cm. just like a fat earthworm.

But we don't know why the appendix is there. It doesn't help digestion at all, it just hangs there waiting to get into trouble. It might be a holdover on the evolutionary chain. Lower animals that eat plants and grass have something similar. Cows have larger tube-like outpouchings of the bowel function that break down nutrients. So most anatomists believe that the human appendix is simply a rudimentary remnant of our bowel’s evolution.

Inflammation of the appendix is very common in humans – your chances of needing an appendectomy as you stroll through life are about one in ten. Appendicitis is most common in adolescents and young adults, and it’s usually caused by obstruction of this tube, either by a small piece of stool, or by enlargement of the lymph tissue that surrounds the appendix. Once there's an obstruction, pressure builds up in the appendix as bacteria starts to multiply. If untreated, the appendix bursts and releases bacterial contaminants into the abdominal cavity. That's a condition known as peritonitis. And it's dangerous. Thirty percent of people with untreated appendicitis die.

What should you look for? Typically the most prominent symptom is pain. It’s first felt around the belly button, then it moves down into the right lower quadrant of the abdomen as the disease progresses. Loss of appetite, nausea and vomiting and a low-grade fever are all common and soon it starts to feel tender over the appendix. Here’s what a normal appendix looks like and here’s an infected one.

Though acute appendicitis is common, it can be difficult to diagnose, especially in the very young, in the elderly or in the situation where the appendix is not anatomically in the usual position. Perforation of the appendix often occurs after about 18 to 24 hours and this complication increases the risk considerably. Blood work and ultrasound can help make the diagnosis, as can C.T. scanning. Here’s an example of what an acute appendix looks like on a CT scan.

The treatment for acute appendicitis is of course appendectomy, the surgical removal of the appendix. It may leave a very small scar, but you sure won’t miss this little piece of tissue. And who knows, perhaps in another million years or so, humans will evolve to the point where we don’t even have an appendix anymore!