Of all the organs in the human body 'Appendix' is the only organ, which has no functions, is unwanted and can easily be dispensed with. However, if infected, it gets angry and can be life threatening.
The Appendix is commonly referred to as a classic example of a vestigial organ. It is a small sac connected to the large intestine at the apex of the caecum below the entrance of the ileum. It is a slender tubular organ of the size of the little finger. It has its own artery for blood supply called the appendicular artery in the appendicular mesentery.
Earlier it was considered as a vestigial organ without any functions whatsoever. However, newer evidence suggests that it has a most likely function in the lymphatic system. It is one of the areas of the colon where lymphatic tissue found in the appendix is high.
The most common diseases of the appendix (in humans) are:
Appendicitis: Like in all cases,” itis” means inflammation. Appendicitis means inflammation of the appendix, caused by bacterial infection. It is quite possible for the intestinal matter to get logged in the appendix, which leads to bacterial infection. If not correctly diagnosed and promptly treated, the appendix will eventually burst leading to septecmia and eventually death.
Symptoms: Diagnosis is very important and has to be prompt and accurate. The classical signs and symptoms of appendicitis are:
- Abdominal pain that usually starts in the middle of the abdomen (just above the belly button), and moves to the right lower side of the abdomen called the right iliac fossa or the right flank.
- Nausea and vomiting
- Pain when the right side of the abdomen is touched. Pain becomes intense and unbearable if pressure is applied.
- Low grade fever
- Inability to pass gas
- Constipation or diarrhea
Diagnosis: is based on history and physical examination backed by blood tests and other diagnostic procedures.
A standard test for appendicitis when abdominal pain is present is maximum tenderness at McBurney's point, which is located on the right hand side one-third of the distance between the hipbone and the navel, or approximately one hand's width. Due to muscle rigidity, there is a tendency on the part of the patient to keep his thigh flexed to avoid pain.
Another way to suspect this serious disease when the pain is not intense is to press the abdomen over the Mcburney’s point, keep pressing and then release it suddenly. This will exhibit sudden pain, which we call “rebound tenderness”, If this is present we must suspect appendicitis and adopt strict bed rest and institutional treatment with fluids and adequate preparations for surgical removal of the appendix called 'Appendicectomy'.
Treatment: This could be conservative or surgical procedure depending upon the severity of pain and the condition of the patient. Patients with a suspected appendicitis should never be allowed to go home or stay at home but have to be hospitalized for observation at least for 48 hours.
Positive signs on clinical examination, fever, high WBC counts and patient in severe agony warrant immediate surgical intervention and removal of the appendix. Borderline cases must be advised to report at once to a surgeon if a similar episode repeats.
Prognosis depends on how fast we can organize surgical intervention in severe cases and how well the health status of the victim is.
Since the appendix can be readily sacrificed it must be removed on slightest suspicion of appendicitis to avoid life-threatening consequences if neglected. The golden rule is to remove the appendix if the patient is a victim of repeated episodes of appendicular type of pain. To err on the wrong side is better than inviting serious complications including loss of life.
Carcinoid of the Appendix:
Carcinoid tumors can occur anywhere in the Gastro-intestinal tract. In the intestines the tip of the appendix is the common site for carcinoid tumor to occur. There may be more than one of these small growths, which are solid and yellow-colored.
These are usually an incidental finding while performing an appendicectomy operation or as a secondary procedure for some other abdominal surgery. While carcinoid tumors in the GI tract are potentially malignant, the vast majority of appendiceal tumors pursue a benign course.
Just as the appendix itself is a myth appendicitis also turns out as a greater myth. There are cases when the appendix is removed and found absolutely normal after its removal. There are few cases when a normal appendix is removed just like that when the abdomen is opened for some other surgery to avoid any problems which the appendix might cause if let loose on its own! There are also cases when the diagnosis is missed, or the patient did not present with classical signs and symptoms of appendicitis or there is no time for surgery, and later autopsy reveals that the cause is acute appendicitis!
More importantly the appendix presents itself at various positions deviating from the usual normal position. If this happens diagnosis becomes more difficult and the patient may face serious consequences for no fault of any body.
The problems in diagnosing appendicitis are as complicated as the evolution of the appendix itself.