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The human appendix averages 9 cm (3.5 in) in length, ranging from 5 to 35 cm (2.0 to 13.8 in). The diameter of the appendix is 6 mm (0.24 in), and more than 6 mm (0.24 in) is considered a thickened or inflamed appendix. The longest appendix ever removed was 26 cm (10 in) long. [3]
Harry Hancock performed the first abdominal surgery for appendicitis in 1848, but he did not remove the appendix. [26] In 1889 in New York City, Charles McBurney described the presentation and pathogenesis of appendicitis accurately and developed the teaching that an early appendectomy was the best treatment to avoid perforation and peritonitis.
Ileum, caecum and colon of rabbit, showing Appendix vermiformis on fully functional caecum The human vermiform appendix on the vestigial caecum. The appendix was once believed to be a vestige of a redundant organ that in ancestral species had digestive functions, much as it still does in extant species in which intestinal flora hydrolyze cellulose and similar indigestible plant materials. [10]
Inflamed appendix removal by open surgery Laparoscopic appendectomy. Laparoscopic view of a phlegmonous cecal appendix with fibrinous plaques, located in the right iliac fossa. The surgical procedure for the removal of the appendix is called an appendectomy. Appendectomy can be performed through open or laparoscopic surgery.
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In humans, the vermiform appendix is sometimes called a vestigial structure as it has lost much of its ancestral digestive function.. Vestigiality is the retention, during the process of evolution, of genetically determined structures or attributes that have lost some or all of the ancestral function in a given species. [1]
Specifically, the cecum and appendix are formed by the enlargement of the postarterial segment of the midgut loop. The proximal part of the bud grows rapidly to form the cecum. The lateral wall of the cecum grows much more rapidly than the medial wall, with the result that the point of attachment of the appendix comes to lie on the medial side.
The appendix apparently serves as a "safe house" for the good bacteria, protecting that supply of bacteria from contamination and facilitating a re-start of the system once the contaminating organism has been eliminated. (J.