Appendicitis? If in doubt, prefer an operation

100,000 people are removed in Germany each year of the cecum. In many of them, the appendix is ​​not even inflamed. Few adults with inflamed cecum retain the organ - antibiotics replace the operation.

Infection at the worm appendage
In the narrow sense, not the cecum but the appendix, a rudimentary organ, becomes inflamed.

The appendix is ​​an unimportant organ that doctors often remove (bilderzwerg / fotolia.com)

Access to the cecum is blocked
Mostly an opening between the appendix and the appendix clogged, usually by indigestible leftovers. However, there is intestinal secretions in the appendix, and this can no longer be done in the cecum. The fluid presses, and the appendix fires.

Bacteria, viruses, parasites?
However, intestinal infections, bacteria, viruses and parasites are suspected to cause so-called appedicitis.

A superfluous organ?
Much more often than other organs, the appendix is ​​operated away during an infection. There are good reasons for this: The vermiform appendage is probably superfluous as an organ, it serves at most as a residence of beneficial bacteria.

In any case, the patients lack nothing if they live without the "appendage" of the appendix.

Operation instead of danger to life
However, any inflammation can worsen and break through the cecum. If that happens, the appendix ruptures. Then the germs stored there come into the abdominal cavity.

But here are vital organs, and if the infection spreads to the abdomen, it can cost a living. A simple operation, which usually has no consequences, runs counter to the risk of a fatal illness.

Healthy worm processes also come under the knife
However, doctors also cut out healthy appendages. Up to 40% of the cut out worm shoots are not infected at all.
Is it a botch? It is not that easy. Typical of "appendicitis" are pains that move from the navel into the right lower abdomen.

However, abdominal pain can have a variety of causes - from an ectopic pregnancy to food poisoning. This means that no doctor can be absolutely sure before surgery that the appendix is ​​inflamed.

Even after the surgery, no clarity
Before the operation, ultrasound, physical examination and blood count are just suspicions. Sometimes even on the out-cut vermiform appendix, it is not possible to detect whether there is inflammation. Only the microscopic examination brings clarity.

Appendicitis: Antibiotics can often prevent surgery
A 2015 study of 530 adult volunteers found that simple inflammation of the appendix can be cured by up to 70% with antibiotics. A CT had previously proven simple appendicitis.

Diagnosis too expensive?
Skeptical surgeons consider such a diagnosis too time-consuming. A computerized tomography would greatly extend the diagnostics. In addition, you would need to observe the patients who take antibiotics, stationary. This was disproportionate to the fact that every third patient would be operated on despite CT and antibiotics in the end.

Study is for adults only
In addition, the study would only apply to adults. However, children are particularly at risk because of their weaker immune system that the infection extends to vital organs. That's why the operation is still the first choice for them. (Dr. Utz Anhalt)