Appendicitis historical perspective

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Farwa Haideri [2]

Overview

The first description of appendicitis dates back to the early 1500s from a French doctor and prolific writer, Jean Francois Fernel, in "Universa Medicina". However, Appendicitis was first officially described in 1886 by Reginald J. Fitz of Harvard University. Since then, the appendectomy has become one of the most common surgical procedures. The laparoscopic appendectomy was invented in the 1980s, and has led to reduced length of hospital stay, a decreased risk of infection, and a reduction in post-operative pain.

Historical Perspective

Discovery

• The earliest known drawing of the appendix was in 1492 by the great artist and scientist, Leonardo da Vinci.
• Berengarius Carpus, a professor of surgery at Pavia and Bologna, gave the first description of the appendix in 1522.
• Physician Gabriele Fallopius was the first to compare the appendix to a worm in 1561.
• In 1579, Johann Bauhin proposed the theory that the appendix provided function in intrauterine life as a storage for feces.

Landmark Events in the Development of Treatment Strategies

• The first description of appendicitis is thought to date back to the early 1500s by French doctor and prolific writer, Jean Francois Fernel, in "Universa Medicina".

• During the late 1600s, Lorenz Heister was the first surgeon to perform post-mortem sections of appendicitis and gave an unequivocal description of a perforated appendix and abscess.
• Francois Melier suggested surgical removal of the appendix in 1827, although his paper was largely ignored.
• Guillaume Dupuytren, a leading surgeon in Paris, gave strong opposition to Melier's suggestion and was convinced that the cause of right lower quadrant inflammatory disease was due to the cecum.
• During the 1840s, four well-known physicians, Thomas Hodgkin, Richard Bright, Thomas Addison, and Voltz all pointed towards the appendix as the source of the disease.
• Reginald. J. Fitz, an anatomic pathologist from Harvard University, described appendicitis in his paper "Perforating Inflammation of the Vermiform Appendix" on June 18th, 1886 to the Association of American Physicians.
• Reginald. J. Fitz was the first person to provide a clear description of the pathology, diagnosis, treatment of appendicitis and also coined the term appendicitis.
• The first actual surgical removal of the appendix was done by Caudius Amyand at St. Georges Hospital in London, when he removed a perforated appendix found in a scrotal hernia.

Development of Treatment Strategies

• Charles McBurney from the College of Physicians and Surgeons in New York City pioneered the diagnosis and early operative intervention of appendicitis.
• The McBurney point was described in 1889, which is one-third of the way laterally from the anterior superior iliac spine to the umbilicus on the right side of the abdomen.
• The McBurney incision was coined in 1894.
• In 1902, A.J. Oschner advocated for a non-operative treatment of peritonitis.

• The laparoscopic appendectomy surgery was invented by Kurt Semm in 1980.