Many appendectomies may not be needed, study finds

SMU Economics Professor Thomas B. Fomby and Statistics Professor Wayne A. Woodward contributed to a new study by the University of Texas Southwestern Medical Center that raises questions about the need for appendectomies in many cases.

By Rita Rubin

Appendectomies are the most common emergency general surgical procedure in the USA, but a new study suggests many are unneeded.

According to conventional medical wisdom dating back to the late 19th century, if you don't remove an inflamed appendix, it could burst and lead to potentially life-threatening complications such as an abscess or peritonitis.

The study, out today in the Archives of Surgery, implies that perforated, or ruptured, appendicitis is a different disease from non-perforating appendicitis. In other words, some inflamed appendixes won't burst, no matter how long you wait to remove them.

"I don't think the disease is as straightforward as we thought, and I believe it needs to be revisited," says senior author Edward Livingston, chief of gastrointestinal and endocrine surgery at the University of Texas Southwestern Medical Center in Dallas.

Though the cause of appendicitis isn't known, Livingston's study links non-rupturing — but not ruptured — disease to viral infections, an association supported by reports of clusters, or outbreaks, of appendicitis cases.

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