What are we doing with an appendix? Ever wondered that? I’ve taken out quite a few of them and often thought they were about the most useless organ in the human body. We considered them a biologic time bomb.
Given any other excuse to be in the abdomen – ulcer surgery, hysterectomy –doctors always took a little extra time and removed the appendix while we were there. We figured we were saving the patient an appendectomy in the future.
Most body parts have rather obvious use: the heart, the brain or left elbow.
But the lowly appendix seemed only good for teaching interns a surgical procedure.
But that might not be the whole story.
The appendix is a hollow tube about the size and shape of your little finger. It is attached to the base of the large intestine (colon) and is a pathway to nowhere. It is a short tube that just ends: think of a long skinny balloon before it’s blown up. The tube contains the same stuff that the colon holds, liquid feces. It adds about a teaspoon of capacity to your colon.
When an appendix gets in trouble it’s due to the tube getting plugged. A fecolith
(colorful term) lodges in the passage way and plugs the plumbing. Swelling starts because of the blockage and if the swelling gets bad enough the appendix will rupture. This ruptured appendix leaks puss and liquid feces into the peritoneal cavity.
The result is not surprising: massive infection. The usual course of appendicitis is initially losing your appetite, feeling sick, and having pain in your upper abdomen. The pain gradually moves to the right lower abdomen, near the belt line. From the onset of symptoms, an inflamed appendix rarely leaks before 24 hours. That means there is plenty of time to get some medical attention.
But the question remains: why in the world do we even have this thing?
Science has discovered mysterious immune-modifying cells in the appendix. These seem to serve a function in training our immune system. It is important for the body to get straight which germs to fight against and which ones to peacefully coexist.
Besides possibly having an immune system function, the lowly appendix turns out to be a well-built tubular structure handy for rebuilding internal body parts. Urinary tract reconstructions frequently make use of the appendix. So we stopped removing a normal appendix when we were there for another reason.
The whole treatment of acute appendicitis has been evolving. Traditionally there was one, and only one treatment for acute appendicitis – remove it. Recent studies show antibiotics work in treating the acute appendicitis, and work as well as surgery. It’s certainly a heck of a lot easier on the patient to use antibiotics.
Once again, the more you study the human body, the more you appreciate the design. We’ve learned that even something as lowly as the appendix is there for a reason.
As always, take care.
Dr. B