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Appendicitis could be a viral infection, says study

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Thursday, January 21, 2010, 22:13 This news item was posted in health category and has 0 Comments so far.

Appendicitis could be the result of viral infection, according to a new report in Archives of Surgery.

Appendicitis may be caused by undetermined viral infection or infections says the study by UT Southwestern Medical Center after evaluating data over a 36-year period from the National Hospital Discharge Survey.

The researchers screened the diagnosis codes for admissions for appendicitis, influenza, rotavirus and enteric infections.

Seasonal variations and clustering of appendicitis cases support the theory that appendicitis may be a viral disease, like the flu, researchers said.

The researchers studied appendicitis trends from 1970 to 2006 and came out with the conclusion that immediate removal of appendix may not be necessary.

Appendicitis cases peaked in the years 1977, 1981, 1984, 1987, 1994 and 1998. Statistical data suggest that these peals may be outbreaks of appendicitis.

The researchers also uncovered some seasonal trends for appendicitis and documented a slight increase in appendicitis cases during the summer.

Appendicitis doesn’t often lead to a burst appendix if the organ is not removed quickly, said Dr. Edward Livingston, chief of GI/endocrine surgery at UT Southwestern and lead author of the report.

“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,” stated Dr. Livingston.

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, according to Dr. Livingston.

However, emergency surgery for patients with appendicitis is open for debate.

Researchers collated evidence from sailors at sea without access to immediate surgery and from some children’s hospitals where emergency surgery is not the norm.

Then they arrived at the conclusion that non-perforated appendicitis may resolve without surgery.

What is appendicitis?

The appendix is a fingerlike pouch attached to the large intestine and located in the lower right area of the abdomen. Scientists are not sure what the appendix does, if anything, but removing it does not appear to affect a person’s health. The inside of the appendix is called the appendiceal lumen. Mucus created by the appendix travels through the appendiceal lumen and empties into the large intestine.

Appendicitis is normally treated by removing the appendix. Prompt surgery decreases the likelihood the appendix will burst.

Surgery to remove the appendix is called appendectomy and can be done two ways. The older method, called laparotomy, removes the appendix through a single incision in the lower right area of the abdomen.

The newer method, called laparoscopic surgery, uses several smaller incisions and special surgical tools fed through the incisions to remove the appendix.

Laparoscopic surgery leads to fewer complications, such as hospital-related infections, and has a shorter recovery time.

Surgery occasionally reveals a normal appendix. In such cases, many surgeons will remove the healthy appendix to eliminate the future possibility of appendicitis.

Occasionally, surgery reveals a different problem, which may also be corrected during surgery.

Sometimes an abscess forms around a burst appendix—called an appendiceal abscess.

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