Just when you thought that there are some medical treatments which will never change, along comes some new research which blows the status quo away.
Appendectomy or removal of the appendix has, for over hundred years, been considered the gold standard and in fact the only treatment for acute appendicitis. A recently published study provides evidence that there might be another way. Researchers divided patients with early acute appendicitis into two groups: One group underwent the usual treatment-that is surgical removal of the appendix. The other group were treated with antibiotics only.
Guess what? Those patients who were treated only with antibiotics not only did not develop peritonitis from rupture of the appendix, they also were about 30% less likely to suffer complications. Those who had the surgery had more complications as opening up the belly does result in higher risks of infection, scar tissue and pain than just antibiotic treatment.
This result goes against a long held medical dogma: Appendicitis can only be treated with appendectomy. Antibiotics are given but never without the surgery. If some patients truly can be managed without the surgery, this would not only reduce complications, it also would save beaucoup dollars.
Still, before mainstream medicine can or should change its course, several caveats are in order. For one, this is a single study and would need to be repeated. Patients need to be carefully screened, as this surgery free course, requires that there be no evidence of rupture of the appendix or abscess formation. Thus, all patients would need to have a CT scan. CTs do expose patients to quite a bit of radiation. In fact, many patients for this reason are taken to surgery based on ultrasound results alone. (Ultrasound has no ionizing radiation).
Another problem is that with this study, about 20% of the patients given antibiotics alone required appendix removal within one year. 20% is a lot of people who would need a second CT scan and hospitalization.
For the present, this study will be looked at very carefully and if the results can be reproduced there could in the future be an alternative to an appendectomy, at least for some patients. Perhaps, patients might be offered a choice of immediate surgery or antibiotics with a wait and see approach.
It just goes to show you that, in medicine as in life, there are indeed no sacred cows.