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===Landmark Events in the Development of Treatment Strategies===
===Landmark Events in the Development of Treatment Strategies===
*The first description of appendicitis is thought to date back to the early 1500's by French doctor and prolific writer, Jean Francois Fernel, in the "Universa Medicina". He describes a patient:<ref>{{Citation
*The first description of appendicitis is thought to date back to the early 1500s by French doctor and prolific writer, Jean Francois Fernel, in "Universa Medicina". He describes a patient:<ref>{{Citation
| last1  = Fernel
| last1  = Fernel
| first1 = Jean Fracois  
| first1 = Jean Fracois  

Revision as of 19:55, 30 November 2015

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Appendicitis was first officially described by Reginald J. Fitz of Harvard University in 1886. Since that time, the appendectomy has become one of the most common surgical procedures. The laparoscopicappendectomy was invented during the 1980s, and has led to reduced length of hospital stay, a decreased risk of infection, and a reduction in post-operative pain.

Historical Perspective

Discovery

  • The earliest known drawing of the appendix was by the great artist and scientist, Leonardo da Vinci, in 1492.[1]
  • Berengarius Carpus, a professor of surgery at Pavia and Bologna, gave us the first description of the appendix in 1522.[2]
  • Physician Gabriele Fallopius was the first to compare the appendix to a worm in 1561.[2]
  • In 1579, Johann Bauhin proposed the theory that the appendix provided function in intrauterine life as a storage for feces.[2]

Landmark Events in the Development of Treatment Strategies

  • The first description of appendicitis is thought to date back to the early 1500s by French doctor and prolific writer, Jean Francois Fernel, in "Universa Medicina". He describes a patient:[3]

"A girl of seven afflicted with diarrhea passed for many days from the bowels a white putrid and foul material. She swelled up with increasingly severe pains and repeated loss of consciousness and vomiting of a fecal liquid. She died miserably two days later. On opening the body, the caecum intestinum was narrowed and constricted....and material opened up itself an unusual route by necrosis and perforation".

  • In the late 1600s, Lorenz Heister was the first surgeon to perform post-mortem sections of appendicitis, and gave an unequivocal description of a perforated appendix and abscess.[4]
  • Francois Melier suggested surgical removal of the appendix in 1827, although his paper was largely ignored.
  • Guillaume Dupuytren, a leading surgeon in Paris gave strong opposition to Melier's suggestion, and was convinced that the cause of right lower quadrant inflammatory disease was due to the cecum.[5]
  • During the 1840's, four well-known physicians, Thomas Hodgkin, Richard Bright, Thomas Addison and Voltz all pointed towards the appendix as the source of the disease.
  • Reginald. J. Fitz, anatomic pathologist from Harvard University, described his paper "Perforating Inflammation of the Vermiform Appendix" on June 18th, 1886 to the Association of American Physicians.He was the first person to provide a clear description of the pathology, diagnosis and treatment of appendicitis.[6]
    • This is when the term "appendicitis" was used for the first time.
  • The first actual surgical removal of the appendix was done by Caudius Amyand at St. Georges Hospital in London, when he removed a perforated appendix found in a scrotal hernia.

Development of Treatment Strategies

  • Charles McBurney from the College of Physicians and Surgeons in New York City pioneered the diagnosis and early operative intervention of appendicitis.[7]
  • The McBurney point was described in 1889, which is one third of the way from the anterior superior iliac spine in the right upper quadrant of the abdomen.
  • The McBurney incision was coined in 1894.
  • A.J. Oschner in 1902, advocated for a non-operative treatment of peritonitis, and he stated:

"After my first operation I was completely disgusted because after cutting my patient lengthwise and crosswise, I found, behind the ascending colon, an inoffensive looking, shriveled up remains of what had been an appendix. I felt that I had subjected my patient to a very grave operation without a corresponding benefit". [8]

  • The laparoscopic appendectomy surgery was invented by Kurt Semm in 1980.

References

  1. Williams GR (1983). "Presidential Address: a history of appendicitis. With anecdotes illustrating its importance". Annals of Surgery. 197 (5): 495–506. PMC 1353017. PMID 6342553. Retrieved 2012-08-09. Unknown parameter |month= ignored (help)
  2. 2.0 2.1 2.2 McCarty, Arthur C. "History of Appendicitis Vermiformis Its diseases and treatment." The Innominate Society http://www.innominatesociety.com/Articles/History%20of%20Appendicitis.htm (1927). APA
  3. Fernel, Jean Fracois (1567), Universa Medicina (1 ed.), New York, New York: Cambridge University Press
  4. Shklar G, Chernin DA (2007). "Lorenz Heister and oral disease with the original text from his papers". Journal of the History of Dentistry. 55 (2): 68–74. PMID 17848045. |access-date= requires |url= (help)
  5. Seal A (1981). "Appendicitis: a historical review". Canadian Journal of Surgery. Journal Canadien De Chirurgie. 24 (4): 427–33. PMID 7023636. Unknown parameter |month= ignored (help); |access-date= requires |url= (help)
  6. Carmichael DH (1985). "Reginald Fitz and appendicitis". Southern Medical Journal. 78 (6): 725–30. PMID 3890203. Retrieved 2012-08-09. Unknown parameter |month= ignored (help)
  7. Musana KA, Yale SH (2005). "Murphy's Sign". Clinical Medicine & Research. 3 (3): 132. PMC 1237152. PMID 16160065. Retrieved 2012-08-09. Unknown parameter |month= ignored (help)
  8. Ochsner A (1981). "The conservative treatment of appendiceal peritonitis". JAMA : the Journal of the American Medical Association. 246 (21): 2453–4. PMID 7299967. Retrieved 2012-08-09. Unknown parameter |month= ignored (help)

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