Appendicitis may be caused by an as yet unknown viral infection, a new study at UT Southwestern Medical Center has suggested.
The team analysed data over a 36-year period from the National Hospital Discharge Survey to come up with their conclusion.
According to senior author of the study Dr. Edward Livingston, chief of GI/endocrine surgery at UT Southwestern, their report suggests that appendicitis may not necessarily cause the appendix to burst if the organ is not removed quickly.
He said: "Just as the traditional appendix scar across the abdomen is fast becoming history, thanks to new single-incision surgery techniques that hide a tiny scar in the bellybutton, so too may the conventional wisdom that patients with appendicitis need to be operated on as soon as they enter the hospital.
"Patients still need to be seen quickly by a physician, but emergency surgery is now in question."
Dr. Livingston pointed out that evidence from sailors at sea without access to immediate surgery and from some children's hospitals, where emergency surgery was not done, hinted that non-perforated appendicitis might be resolved without surgery.
For their study, the researchers screened the diagnosis codes for admissions for appendicitis, influenza, rotavirus and enteric infections. They discovered that seasonal variations and clustering of appendicitis cases support the theory that appendicitis may be a viral disease.
Statistical data revealed peaks, which may be outbreaks of appendicitis, in the years 1977, 1981, 1984, 1987, 1994 and 1998. Also, the researchers found some seasonal trends for appendicitis, documenting a slight increase in appendicitis cases during summers.
Dr. Livingston said: "The peaks and valleys of appendicitis cases generally matched up over time, suggesting it is possible that these disorders share common etiologic determinates, pathogenetic mechanisms or environmental factors that similarly affect their incidence."
"Though appendicitis is fairly common, it still remains a frustrating medical mystery...While we know surgical removal is an effective treatment, we still don't know the purpose of the appendix, nor what causes it to become obstructed," he added.
The study has been published in the January issue of Archives of Surgery.