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Appendicitis? If in doubt, prefer surgery


100,000 people have their appendix removed in Germany every year. In many of them the appendix is ​​not even inflamed. Few adults with inflamed appendix keep the organ - antibiotics replace the surgery.

Infection on the appendix
In the narrow sense, it is not the appendix that ignites, but the appendage, a rudimentary organ.

Access to the appendix blocked
An opening between the worm process and appendix is ​​usually blocked, usually due to indigestible food residues. However, intestinal secretion is in the worm process, and this can no longer run into the appendix. The liquid squeezes and the worm process ignites.

Bacteria, viruses, parasites?
However, intestinal infections, bacteria, viruses and parasites are also suspected of causing so-called appedicitis.

An unnecessary organ?
If an infection occurs, the appendix is ​​operated on much more often than other organs. There are good reasons for this: the worm process is probably superfluous as an organ, it serves as a home for useful bacteria.

In any case, nothing is lacking for patients if they live without the “appendage” of the appendix.

Operation instead of danger to life
However, any inflammation can worsen and break the appendix. If this happens, the appendix tears. Then the germs stored there come into the abdominal cavity.

But here are vital organs, and if the infection spreads to the abdomen, it can cost life. A simple operation, which usually has no consequences, runs the risk of a fatal disease.

Healthy worm processes also come under the knife
However, doctors also cut out healthy worms. Up to 40% of the worms that have been cut out are not infected at all.
Is it a botch? It is not that easy. Pain typical of "appendicitis" is drawn from the navel to the right lower abdomen.

However, abdominal pain can have various causes - from an ectopic pregnancy to food poisoning. This means: Before an operation, no doctor can be absolutely certain that the appendage is inflamed.

No clarity even after the operation
Before the operation, ultrasound, physical examination and blood count only give rise to suspicion. Sometimes even the cut out worm does not show whether there is an inflammation. Only microscopic examination brings clarity.

Appendicitis: Antibiotics can prevent interventions more often
A 2015 study of 530 adult subjects found that 70% of simple inflammations of the appendage can be cured with antibiotics. A CT had previously shown simple appendicitis.

Diagnosis too complex?
Skeptical surgeons consider such a diagnosis too complex. Computer tomography would greatly expand diagnostics. In addition, one would have to observe the patients taking antibiotics in hospital. This is disproportionate to the fact that one in three patients would ultimately be operated despite CT and antibiotics.

Study only applies to adults
In addition, the study was only for adults. However, children, in particular, are particularly at risk from their weaker immune system that the infection spreads to vital organs. That is why surgery is still their first choice. (Dr. Utz Anhalt)

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Video: Laparoscopic Appendectomy Surgery. Nucleus Health (September 2021).