Appendicitis historical perspective: Difference between revisions

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*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 <ref name="pmid7023636">{{cite journal |author=Seal A |title=Appendicitis: a historical review |journal=[[Canadian Journal of Surgery. Journal Canadien De Chirurgie]] |volume=24 |issue=4 |pages=427–33 |year=1981 |month=July |pmid=7023636 |doi= |url= |accessdate=2012-08-09}}</ref>. Finally in the 1840's, four well known physicians of the time Thomas Hodgkin, Voltz, Addison and Bright all pointed towards the appendix as the source of the disease.
*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 <ref name="pmid7023636">{{cite journal |author=Seal A |title=Appendicitis: a historical review |journal=[[Canadian Journal of Surgery. Journal Canadien De Chirurgie]] |volume=24 |issue=4 |pages=427–33 |year=1981 |month=July |pmid=7023636 |doi= |url= |accessdate=2012-08-09}}</ref>. Finally in the 1840's, four well known physicians of the time Thomas Hodgkin, Voltz, Addison and Bright all pointed towards the appendix as the source of the disease.
* There was no definitive treatment for over 50 years after Melier's paper, and the disease was called many names, such as typhilitis, pertyphilitis, tuphloenteritis, paratyphilitis, cecitis and iliac passion.
* There was no definitive treatment for over 50 years after Melier's paper, and the disease was called many names, such as typhilitis, pertyphilitis, tuphloenteritis, paratyphilitis, cecitis and iliac passion.
* Reginald. J. Fitz, anatomic pathologist from Harvard University, described his paper "Perforating Inflammation of the Vermiform Appendix" on 18th June 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. This is when the term "appendicitis" was used for the first time.
* Reginald. J. Fitz, anatomic pathologist from Harvard University, described his paper "Perforating Inflammation of the Vermiform Appendix" on 18th June 1886 to the Association of American Physicians <ref name="pmid3890203">{{cite journal |author=Carmichael DH |title=Reginald Fitz and appendicitis |journal=[[Southern Medical Journal]] |volume=78 |issue=6 |pages=725–30 |year=1985 |month=June |pmid=3890203 |doi= |url=http://meta.wkhealth.com/pt/pt-core/template-journal/lwwgateway/media/landingpage.htm?issn=0038-4348&volume=78&issue=6&spage=725 |accessdate=2012-08-09}}</ref>. He was the first person to provide a clear description of the pathology, diagnosis and treatment of appendicitis. 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.
* 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.



Revision as of 19:37, 9 August 2012

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

Overview

Appendicitis was first described

Discovery

  • The knowledge of the appendix itself dates back to ancient Egypt. Coptic jars from from the ancient egyptian times refer to "the worm of the intestine". The earliest known drawing of the appendix was by the great artist and scientist, Leonardo da Vinci, in 1492. The first description of the appendix was by Physician and Anatomist Jacopo Berengaro Dan Carpi in 1521. [1] In 1543, Andrea Vasulius portrayed a clear illustration of the appendix in "De Humani Corporis Fabrica.
  • 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:

"A girl of seven afflicted with diarrhoea 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".

  • Lorenz Heister in the late 1600's was the first person to perform post-mortem sections of appendicitis, and gave an unequivocal description of a perforated appendix and abscess [2].
  • 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 [3]. Finally in the 1840's, four well known physicians of the time Thomas Hodgkin, Voltz, Addison and Bright all pointed towards the appendix as the source of the disease.
  • There was no definitive treatment for over 50 years after Melier's paper, and the disease was called many names, such as typhilitis, pertyphilitis, tuphloenteritis, paratyphilitis, cecitis and iliac passion.
  • Reginald. J. Fitz, anatomic pathologist from Harvard University, described his paper "Perforating Inflammation of the Vermiform Appendix" on 18th June 1886 to the Association of American Physicians [4]. He was the first person to provide a clear description of the pathology, diagnosis and treatment of appendicitis. 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.
  • 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".

  • The laparoscopic surgery was invented in 1980 by Semm.

Impact on Cultural History

  • The appendectomy has become one of the most common surgical procedures.
  • Advances in modern surgery, anesthesia, antibiotics, and imaging have lead to an improved outcome and a significant reduction in mortality.
  • Laparoscopic surgery has lead to a decreased length of hospital stay, reduced risk of wound infection, reduced amount of post-operative pain, and more rapid return to daily activities for the patient.

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. 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)
  3. 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)
  4. 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)