For decades, it seemed like the appendix would go the way of 8-track players, pagers, and the phonograph. Outdated, obsolete, not worth keeping around. Surgeons performed appendectomies like it was spring cleaning – when in doubt, cut it out. But then the tides began to turn as medicine started to question the long-held belief that the appendix is a defunct organ (on a good day) or a ticking time bomb (on a very bad one). In this episode, we trace the story of the appendix from its earliest descriptions to the latest advancements in treatment of appendicitis. If you’ve ever wondered whether the appendix actually serves any function and what that function might be, then this is the episode for you!
| History | Biology |
| Ball, Chad G., et al. “Prophylactic surgery prior to extended-duration space flight: Is the benefit worth the risk?.” Canadian journal of surgery 55.2 (2012): 125. | Moris, D., Paulson, E.K. and Pappas, T.N., 2021. Diagnosis and management of acute appendicitis in adults: a review. Jama, 326(22), pp.2299-2311. |
| Bollinger, R. Randal, et al. “Biofilms in the large bowel suggest an apparent function of the human vermiform appendix.” Journal of theoretical biology 249.4 (2007): 826-831. | Bom, W.J., Scheijmans, J.C., Salminen, P. and Boermeester, M.A., 2021. Diagnosis of uncomplicated and complicated appendicitis in adults. Scandinavian journal of surgery, 110(2), pp.170-179. |
| Cobben, Lodewijk PJ, Alexander Mol de van Otterloo, and Julien BCM Puylaert. “Spontaneously resolving appendicitis: frequency and natural history in 60 patients.” Radiology 215.2 (2000): 349-352. | Talan, D.A. and Di Saverio, S., 2021. Treatment of acute uncomplicated appendicitis. New England Journal of Medicine, 385(12), pp.1116-1123. |
| Coldrey, Eric. “Treatment of acute appendicitis.” British medical journal 2.5007 (1956): 1458. | Harnoss, J.C., Zelienka, I., Probst, P., Grummich, K., Mueller-Lantzsch, C., Harnoss, J.M., Ulrich, A., Buechler, M.W. and Diener, M.K., 2017. Antibiotics versus surgical therapy for uncomplicated appendicitis: systematic review and meta-analysis of controlled trials (PROSPERO 2015: CRD42015016882). Annals of Surgery, 265(5), pp.889-900. |
| Collins, Donald C. “Historic phases of appendicitis.” Annals of Surgery 94.2 (1931): 179-196. | Lipsett, S.C., Monuteaux, M.C., Shanahan, K.H. and Bachur, R.G., 2022. Nonoperative management of uncomplicated appendicitis. Pediatrics, 149(5), p.e2021054693. |
| Corner, Edred M. “The function of the appendix and the origin of appendicitis.” British Medical Journal 1.2720 (1913): 325. | Michelson, K.A., Reeves, S.D., Grubenhoff, J.A., Cruz, A.T., Chaudhari, P.P., Dart, A.H., Finkelstein, J.A. and Bachur, R.G., 2021. Clinical features and preventability of delayed diagnosis of pediatric appendicitis. JAMA network open, 4(8), pp.e2122248-e2122248. |
| Fitz, Reginald H. “Perforating inflammation of the vermiform appendix; with special reference to its early diagnosis and treatment. 1.” The American Journal of the Medical Sciences (1827-1924) 184 (1886): 321. | Ponsky, T.A., Huang, Z.J., Kittle, K., Eichelberger, M.R., Gilbert, J.C., Brody, F. and Newman, K.D., 2004. Hospital-and patient-level characteristics and the risk of appendiceal rupture and negative appendectomy in children. Jama, 292(16), pp.1977-1982. |
| Girard-Madoux, Mathilde JH, et al. “The immunological functions of the appendix: an example of redundancy?.” Seminars in immunology. Vol. 36. Academic Press, 2018. | Goyal, M.K., Kuppermann, N., Cleary, S.D., Teach, S.J. and Chamberlain, J.M., 2015. Racial disparities in pain management of children with appendicitis in emergency departments. JAMA pediatrics, 169(11), pp.996-1002. |
| Herrod, Philip JJ, Alex T. Kwok, and Dileep N. Lobo. “Three centuries of appendicectomy.” World journal of surgery 47.4 (2023): 928-936. | Mahajan, P., Basu, T., Pai, C.W., Singh, H., Petersen, N., Bellolio, M.F., Gadepalli, S.K. and Kamdar, N.S., 2020. Factors associated with potentially missed diagnosis of appendicitis in the emergency department. JAMA network open, 3(3), pp.e200612-e200612. |
| KEETLEY, CRB. “The Cavendish Lecture.” 1907 | Agrawal, M., Allin, K.H., Mehandru, S., Faith, J., Jess, T. and Colombel, J.F., 2023. The appendix and ulcerative colitis—an unsolved connection. Nature Reviews Gastroenterology & Hepatology, 20(9), pp.615-624. |
| Kooij, I. A., et al. “The immunology of the vermiform appendix: a review of the literature.” Clinical & Experimental Immunology 186.1 (2016): 1-9. | Addiss, D.G., Shaffer, N., Fowler, B.S. and Tauxe, R.V., 1990. The epidemiology of appendicitis and appendectomy in the United States. American journal of epidemiology, 132(5), pp.910-925. |
| Laurin, Michel, Mary Lou Everett, and William Parker. “The cecal appendix: one more immune component with a function disturbed by post‐industrial culture.” The Anatomical Record: Advances in Integrative Anatomy and Evolutionary Biology 294.4 (2011): 567-579. | Helbling, R., Conficconi, E., Wyttenbach, M., Benetti, C., Simonetti, G.D., Bianchetti, M.G., Hamitaga, F., Lava, S.A., Fossali, E.F. and Milani, G.P., 2017. Acute nonspecific mesenteric lymphadenitis: more than “no need for surgery”. BioMed research international, 2017(1), p.9784565. |
| Macewen, William. “The Huxley Lecture on the Function of the Caecum and Appendix: Delivered at the Opening of the Winter Session of Charing Cross Hospital Medical School on October 3rd, 1904.” British Medical Journal 2.2284 (1904): 873. | |
| Rogozov, Vladislav, and Neil Bermel. “Auto-appendectomy in the Antarctic: case report.” BMJ 339 (2009). | |
| Rógozov, Leonid Ivánovich. “Self operation.” Soviet Antarctic Expedition Information Bulletin. Washington, DC: American Geophysical Union 4 (1964): 223-4. | |
| Sanders, Nathan L., et al. “Appendectomy and Clostridium difficile colitis: relationships revealed by clinical observations and immunology.” World Journal of Gastroenterology: WJG 19.34 (2013): 5607. | |
| Smith, H. F., et al. “Comparative anatomy and phylogenetic distribution of the mammalian cecal appendix.” Journal of evolutionary biology 22.10 (2009): 1984-1999. | |
| Smith, Heather F., et al. “Multiple independent appearances of the cecal appendix in mammalian evolution and an investigation of related ecological and anatomical factors.” Comptes Rendus Palevol 12.6 (2013): 339-354. | |
| Smith, Heather F., et al. “Morphological evolution of the mammalian cecum and cecal appendix.” Comptes Rendus Palevol 16.1 (2017): 39-57. | |
| Smith, Heather F. “A review of the function and evolution of the cecal appendix.” The Anatomical Record 306.5 (2023): 972-982. | |
| Streck Jr, Christian J., and Pinckney J. Maxwell. “A brief history of appendicitis: familiar names and interesting patients.” The american surgeon 80.2 (2014): 105-108. | |
| Thieme, E. T. “Appendicitis: A Ten Year Survey: 1935 Through 1944.” Archives of Surgery 59.3 (1949): 514-526. | |
| Williams, G. Rainey. “Presidential Address: a history of appendicitis. With anecdotes illustrating its importance.” Annals of surgery 197.5 (1983): 495. | |
| https://www.bbc.com/future/article/20180810-villas-las-estrellas-antarctica-base-residents-surgery | |
| What Happened to Appendectomies? |
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