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Study Questions Need for Emergency Appendectomies
Date:1/18/2010

Appendicitis may have viral origins, researchers suggest

MONDAY, Jan. 18 (HealthDay News) -- Appendicitis doesn't necessarily lead to a burst appendix if the organ isn't removed quickly, U.S. researchers say in a new study that challenges traditional belief.

The researchers also theorize that viral infections can cause appendicitis.

"Just as the traditional appendix scar across the abdomen is fast becoming history, thanks to new single-incision surgery techniques that hide a tiny scar in the bellybutton, so, too, may the conventional wisdom that patients with appendicitis need to be operated on as soon as they enter the hospital," the study's senior author, Dr. Edward Livingston, chief of gastrointestinal surgery at the University of Texas Southwestern Medical Center in Dallas, said in a news release from the hospital.

"Patients still need to be seen quickly by a physician, but emergency surgery is now in question," he said.

Livingston and his colleagues analyzed 36 years of data from the National Hospital Discharge Survey and identified seasonal variations and clustering of appendicitis cases that, he said, support the theory that appendicitis may be a viral disease, like the flu.

It's not clear what types of viruses may cause appendicitis, although the researchers said they were able to rule out various intestinal viruses and also ruled out flu and several other common infections as a direct cause.

Their analysis of appendicitis trends from 1970 to 2006 also indicated that immediate removal of the organ might not be necessary in all people, they said. Cases involving sailors at sea without access to immediate surgery and patients at children's hospitals where emergency surgery was not standard practice suggest, according to the researchers, that non-perforated appendicitis can resolve without surgery.

The study is in the January issue of Archives of Surgery.

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