How does the appendix works?

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The appendix is located at the beginning of the colon, where the thin intestine meets the thick intestine, which predisposes it to infection.

Appendix is similar to a tube closed at one end with an opening in the middle through which feces could penetrate so that at its level can quickly develops an infection that could become an emergency.
Appendix measure only about 7-8 inches long.


1. Overview
2. Appendix’s anatomy
3. Appendicitis
4. After how long will the appendix burst?
5. What happens when the appendix ruptures inside?
6. Other conditions of appendix
7. Does the appendix fulfill any function?
8. Appendectomy – a mean of prevention?
9. How will the appendicitis be treated?
10. How is the appendectomy done?

Appendix’s anatomy

Scientists say that the appendix is a remnant of an ancient digestive tract, which seems to have been used by humans in some stage of their development to digest hard leaves and bark.

Currently, appendix appears to have no function in the human body. Because doctors do not really know the purpose of the appendix, they are unable to determine which system belongs.

Outside the appendix is present muscle tissue that, due to lack of activity is much weaker than the muscle tissue that makes up other organs. Membrane that lines the appendix contains lymphatic tissue that produces antibodies. For this reason, some experts believe that the appendix may be a component of the immune system.

Another feature of the appendix is that it produces and secretes a small amount of mucus. Of course, the human body can function perfectly without appendix, but some scientists do not want to declare appendix completely useless.


Appendicitis develops when there is a blockage of the appendix. Since the appendix is closed at both ends, with an opening along the middle section, any blockage prevents normal blood flow causing tissue death.

The blockage may result from a fecal impaction or a illness called lymphoid hyperplasia. Lymphoid hyperplasia may be a result of Crohn’s disease, irritable bowel syndrome, mononucleosis, measles or of gastrointestinal infections.

In this case, the cells create a blockage in the appendix and cause its inflammation being compromised blood flow to the area. Local blood deficiency causes appendix tissue death and may even lead to a rupture of appendix.

After how long will the appendix burst?

The time between formation and blockage when the appendix can perforate is usually 72 hours. The first sign is a vague pain around the navel. As the inflammation develops, pain moves to right side.

Other symptoms within 24 hours include nausea, vomiting, fever, tenderness to touch. In some cases, the patient may have bloated stomach, back pain or constipation.

If you feel that you are suffering from appendicitis, go immediately to the emergency room at the hospital. It is very important to intervene in time when you have appendicitis. Most likely you will have a CT scan or ultrasound so the doctor can see the appendix and establish the correct diagnosis.

With these methods of diagnosing of appendicitis, greatly reduces the number of appendectomies in those suffering from diseases other than appendicitis. In about 20% of cases had removed a healthy appendix.

What happens when the appendix ruptures inside?

It would be advisable to surgically intervene before the appendix ruptures. Once the appendix ruptures, bacteria and infected fluids will be poured into the abdominal cavity. The risk of complications increases 10 times if appendix ruptures before surgery.

Appendectomy is performed, usually on laparoscopy, and in some cases it may be necessary conventional invasive surgery.

Appendicitis complications arise especially when it occur the elderly and the very young people. Both groups are likely to have unusual symptoms, which makes the appendicitis difficult to diagnose.

Young patients often experience diarrhea and vomiting, while the elderly experience less pain. If appendicitis is not properly diagnosed, peritonitis can occur which can cause organ failure and even death.

Appendectomy is the most common surgical emergency of the abdomen and about 20% of patients do not realize they have appendicitis until the appendix rupture occurs.

Because of the symptoms, patients are misdiagnosed with gastroenteritis. Because events are similar, doctors treat gastroenteritis by replacing fluids lost through vomiting and diarrhea and this treatment has no effect on the appendix.

Other conditions of appendix

Appendicitis is the most common disease of the appendix but there are other diseases that can affect the body:

- Carcinoid tumors – These are similar to those found in other organs in the body and can develop in the appendix. Carcinoid tumors are slow growing tumors that may occur anywhere in the gastrointestinal tract.

They can be benign or malignant. Benign carcinoid tumors most often are not diagnosed, while malignant carcinoid tumors can spread to other parts of the body via the blood stream or lymphatic system. Carcinoid tumors can cause carcinoid syndrome, a debilitating condition, but quite rare.

- Appendicular carcinoma – is a rare form of cancer that affects colorectal appendix. Cancer cells growth can trigger a blockage in the appendix, resulting in appendicitis. Appendicular carcinoma can spread to the stomach. Initial diagnosis of appendicular carcinoma is often delayed because symptoms are similar to those of appendicitis.

- Adenomas – are benign tumors that can form in and around the appendix. They are the result of overproduction of skin cells and are rarely malignant. The main problem is that their development compress adenomas appendix, causing appendicitis.

Adenomas can develop in other areas of the body, such as the pituitary gland or thyroid gland as in areas of the body that secrete hormones.

- Diverticular disease – is an uncommon condition with symptoms similar to appendicitis. Appendicitis is most common in people aged under 30 years and diverticular disease in the elderly.

Pain in diverticular disease is intermittent, determining the patients to delay the treatment. Due appendix perforation due to diverticular disease will be necessary to remove the appendix, which is the treatment of choice.

Does the appendix fulfill any function?

Appendix (an about 4 inches long organ) causes much controversy among physicians. They find it difficult to determine whether the appendix has a role in the body or not. While most experts agree that the appendix can be removed without causing any negative impact on patient health, some doctors and researchers believe that the appendix has no function in the immune system.

Others assume that it is a vestigial organ, a remnant of the time when people regularly consumed bark and hard leaves, contributing to their decomposition. Some of the specialists specify that the evolution of the human body will lead to the disappearance of the appendix, and according to other points of view the appendix is believed to remain unchanged in the body.

Appendectomy – a means of prevention?

If the appendix has no purpose but may endanger a person’s life, any person could asks a doctor to remove her appendix as a way to prevent complications?

Because we can’t say yet clear what is the role of the appendix, there is no agreement on prophylactic appendectomy to avoid any medical emergencies.

For years, have circulated some rumors according to which astronauts were removed appendix before traveling into space to avoid a potential medical emergency when they are on orbit. For similar reasons, many people are wondering if it would be necessary appendectomy before traveling abroad.

It seems that the rumor is not true about the astronauts, and most doctors do not recommend preventive appendectomies before traveling abroad. Approximately 7% of people will have appendix removed at some point in their lives.

Given this relatively low percentage and the fact that most insurance plans will not pay prophylactic appendectomy, appendectomy should not be considered as a prophylactic measure.

How will the appendicitis be treated?

Once confirmed the diagnosis of appendicitis, the appendectomy is made. Patient will be given antibiotics before and when appendicitis is suspected. To a small percentage of sufferers, inflammation and infection of appendicitis won’t evolve and will be located in a relatively small area and is even enhanced.

In the patients in this category the situation will improve in a few days. This is called limited appendicitis and can be treated with antibiotics. You may not need to be removed the appendix.

In rare cases, the patient may not see their doctor until they have passed several days or weeks after appendix rupture. In this situation an abscess forms and perforation of the appendix could be covered by it. If the abscess is small, it initially can be treated with antibiotics, but will require drainage. For collection of pus the doctor will introduce a plastic or rubber tube through the skin abscess under ultrasound or CT guidance, to determine the exact location of the abscess.

Appendix will be removed in a few weeks or months after the abscess was treated. This is called interval appendectomy and is done to prevent a second attack of appendicitis.

How is the appendectomy done?

During appendectomy an incision (of 5-7 cm in length) is made in the skin and abdominal wall layers, in the appendix area. The surgeon will detect appendix which is located in the right lower abdomen, will examine the surrounding area to ensure that no additional problem is present, and will remove the appendix, then it will sew the hole in the colon.

If an abscess is present, the pus can be drained with drains that will be introduced to the abscess through the skin. Abdominal incision will be closed.

There are currently appendix removal techniques involving the use of laparoscopy. The laparoscope is a thin telescope which has a camera at one end that allows to the doctor to inspect the abdomen through a small puncture.

If the appendicitis is confirmed, the appendix can be removed with special instruments that will be introduced into the abdomen through a small incision. Benefits of laparoscopic technique include reduced postoperative pain and faster return to normal activities.

Another advantage of laparoscopy is that it allows the surgeon to look inside the abdomen to establish a clear diagnosis, where there is doubt about the diagnosis of appendicitis. For example, laparoscopy is especially useful for women who are of menstruation and ovarian cyst rupture can mimic appendicitis.

When appendix is not torn or perforated during the surgery, the patient is sent home after surgery in one or two days. The period of hospitalization of patients without complications is prolonged (four to seven days), particularly if peritonitis was about.

In the hospital will be given intravenous antibiotics to fight infection and treat any abscess. Occasionally the surgeon may discover that the appendix is normal and does not cause health problems for the patient.

In this case, he will still remove the appendix. The rationale is to remove a normal appendix than to omit or it can not intervene in time properly if appendicitis occurs.



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