The straightforward answer is no, not everyone undergoes an appendectomy. This medical procedure is performed only under specific circumstances, primarily when the appendix becomes inflamed or infected.
The Appendix: Anatomy and Purpose
The appendix is a small, finger-shaped pouch that extends from the cecum, the beginning of the large intestine. It measures about 8 to 10 centimeters (3 to 4 inches) long and is less than 1.3 centimeters (0.5 inch) wide, similar in size to a pinky finger. For many years, it was considered a vestigial organ, meaning it had lost its original function through evolution.
Recent research, however, suggests the appendix may have roles in the immune system and digestive health. Some theories propose it acts as a “safe house” for beneficial gut bacteria, allowing them to repopulate the intestines after illnesses that might deplete them, such as dysentery or cholera. It also contains lymphoid tissue, suggesting a function in the immune system, particularly in B cell-mediated immune responses.
When the Appendix is Removed
The main reason for appendix removal is appendicitis, an inflammation and infection of the appendix. This condition occurs when the opening of the appendix becomes blocked, often by a hardened piece of fecal matter called a fecalith, or by swelling of its walls. The blockage prevents the appendix from emptying its contents, leading to bacterial overgrowth and inflammation.
Symptoms of appendicitis begin with sudden abdominal pain that starts near the belly button and then shifts to the lower right side of the abdomen. This pain intensifies over several hours and can worsen with movement, deep breaths, coughing, or sneezing. Other common symptoms include nausea, vomiting, loss of appetite, a low-grade fever between 99° and 102° Fahrenheit, and changes in bowel habits like constipation or diarrhea.
Diagnosis involves a physical examination, symptom review, and blood tests to check for an elevated white blood cell count, indicating infection. Imaging tests such as an ultrasound or CT scan confirm the diagnosis by showing if the appendix is swollen. If appendicitis is suspected, surgical removal, known as an appendectomy, is performed quickly to prevent the appendix from rupturing, which can lead to serious complications like peritonitis.
Appendix Removal: Not Universal
Despite the common occurrence of appendicitis, most people live their entire lives without experiencing it or needing an appendectomy. The lifetime risk of developing appendicitis is approximately 6.7% for females and 8.6% for males.
Globally, the incidence of appendicitis is about 229.9 cases per 100,000 people per year, with the highest rates observed in individuals aged 10 to 19 years. While it is the most common abdominal surgical emergency worldwide, affecting approximately 250,000 to 300,000 people annually in the United States, it still affects only a percentage of the population. A healthy appendix is left intact.