[Otto Lanz; colourful appendectomist and art collector]. / Otto Lanz.

Otto Lanz (1865-1935) was a Swiss surgeon trained by Theodore Kocher in Berne. In 1902, he was invited to become professor of surgery at the Binnengasthuis hospital in Amsterdam. He was an outstanding surgeon who was well known for his surgery of the thyroid gland and the appendix. He introduced the eponymous Lanz's point in acute appendicitis and also the girdle incision for appendectomy. He was a strong proponent of 'early' appendectomy, as opposed to the conservative approach, at that time the treatment of choice. He was a great connoisseur and passionate collector of Italian Renaissance art. His Italian works of art have been exhibited in a special 'Lanz Hall' at the Rijksmuseum in Amsterdam. During World War II, his collection was acquired for Hitler's proposed Führermuseum but was returned to Amsterdam after the war. A portrait by Jan Toorop and Lanz's former villa on the Museum Square in Amsterdam remind us of this colourful surgeon.

Apuntes históricos y fisiopatológicos sobre apendicitis aguda / Historical and Physiopathological Annotations about Acute Appendicitis

RESUMEN Se realizó un estudio de revisión de corte histórico sobre apendicitis aguda, en el que se profundizó en los aspectos históricos conocidos en mayor o menor grado desde la era Bizantina hasta nuestros días. El objetivo fue actualizar los resultados hallados desde el punto de vista histórico y fisiopatológico y mostrarlos al lector. Para este estudio se realizó una búsqueda a través de las bases de datos Scielo, Medline y PubMed y complementada mediante los buscadores Google, Yahoo y Wikipedia. Se realizó un análisis crítico de los artículos encontrados; se estudiaron también otros artículos de cualquier país, idioma, institución, autor (es) y fecha; de preferencia los nacionales. Se exponen las cuatro teorías relacionadas al origen de esta enfermedad, que son: obstrucción de la luz, ulceraciones mucosas superficiales, la higiene y el rol de la infección, por último, la hipótesis de las fibras dietéticas. Se identificaron aspectos históricos en apendicitis aguda en el tiempo; se aludió a un reporte reciente sobre rasgos gastrointestinales en las distintas especies y las cuatro teorías fisiopatológicas y todas resultaron atractivas(AU)

ABSTRACT A historical review about acute appendicitis was carried out, for which the historical aspects known to a greater or lesser degree were studied in depth. This article covers from the Byzantine era to the present day. The objective is to update the results found from the historical and physiopathological viewpoints. For this study, a search was made through the databases Scielo, Medline and PubMed and complemented by the search engines Google, Yahoo and Wikipedia. A critical analysis of the findings was made and other articles from various countries and institutions, written in other languages, by several author(s) and on different dates were also studied; preferably the nationals. The four theories related to the origin of this disease were exposed: obstruction of light, superficial mucosal ulcerations, hygiene and the role of infection, and finally, the hypothesis of dietary fibers. We identified historical aspects in acute appendicitis over time, as well as referred to a recent report on gastrointestinal traits in the different species and the four physiopathological theories, all of which were attractive(AU)

Five lessons in uncomplicated appendicitis: Can we remove the surgery?

Appendicectomy has remained the treatment of choice for appendicitis for over a century and is the most commonly performed emergency operation in children. However, emerging evidence suggests that appendicectomy may not always be necessary in uncomplicated appendicitis, with early paediatric trials demonstrating that antibiotic-only therapy can be safe and effective. Further rigorously designed and appropriately powered studies are necessarily to establish the place of non-operative management of uncomplicated appendicitis in the future.

[Murphy's Law]. / Appendicitis, appendectomie en de wet van Murphy.

Non-surgical treatment of acute phlegmonous appendicitis has been receiving increasing attention in recent years, representing a reversal of policy. The appendectomy came into vogue at the beginning of the 20th century. It is true that prompt surgical intervention in all patients with appendicitis or an indication thereof almost guarantees success, but it gradually came to be forgotten that this intervention was not always necessary. In this article we will document the historical development of this disease and its treatment, and return to the original reports made by pathologist Reginald Fitz and the internist William Osler to show that their opinion was not black and white. Many surgeons in the Netherlands were also initially more restrained. In the course of time recognition of the natural progression of the disease vanished, until new developments placed this more sharply in the limelight.

A history of the treatment of appendicitis in children: lessons learned.

During the latter half of the 19th century, surgeons increasingly reported performing appendicectomies. Fitz from Harvard, Groves from Canada and Tait from Britain all recorded successful removal of the appendix. McBurney described the point of maximal tenderness in classic appendicitis and also the muscle-splitting incision centred on this point. Priority is given to McArthur in describing the lateral muscle-splitting incision. The direction of the cutaneous incision was later modified by Elliott and Lanz. Incisions that healed well were essential to recovery. Appendicectomy became a 'fashionable' operation after the London surgeon, Treves, removed the appendix of King Edward VII. Through the 20th century, the mortality from appendicitis fell notably with the advent of sulphonamide and penicillin, improvements in fluid therapy and safer anaesthesia. By 1990, diagnostic delay was the main cause of death. Semm performed the first laparoscopic appendicectomy in 1990, roundly criticized at the time for what is now a routine procedure. We view contemporary debates on the indications for appendicectomy, the best approach and how to optimize recovery in the light of the history of this intriguing disease.

[The story of Appendix]. / Príbeh apendixu.

Acute appendicitis is the most frequent acute abdominal emergency. Appendicitis may have been recorded by Aretaeus the Cappadocean in 30 AD. A description of the appendix was provided by the anatomist Berengario de Carpi in 1521. The first appendicectomy was performed by Claudius Amyand in 1735. Turning point in the story of appendix was public lecture of pathologist-physician Reginald Fitz in 1886. Fitz used the term "appendicitis". The area of maximal tenderness with appendicitis was immortalised by Charles McBurney. In the story of appendicitis many names figure, for example Niels Thorkild Rovsing, Jacob Moritz Blumberg, Otto Lanz, Frederic Treves and other. Kurt Semm introduced laparoscopic appendicectomy in 1988.

The evolution of early appendectomy as standard treatment from appendicitis: what we can learn from the past in adopting new medical therapies.

Dr. Reginald Fitz popularized early appendectomy for the treatment of appendicitis with his treatise, "Perforating Inflammation of the Vermiform Appendix," published in 1886 while he worked at the Massachusetts General Hospital along with Dr. Maurice Howe Richardson, the inventor of the Richardson retractor. Their collaboration over the ensuing years led to improvement in outcomes for patients with appendicitis. This historical article describes the importance of this collaboration with information from operative reports, letters, and manuscripts and echoes the discussion today of safely adopting new medical technologies.

[Appendicitis and its history]. / La apendicitis y su historia.

Appendicitis is a common cause of acute abdominal pain. It is caused by the obstruction of the cecal lumen and can evolve to perforation and peritonitis. This article reviews the initial description and history of appendicitis and describes the signs and symptoms used for diagnosis. In today'’s medicine, where technology plays an important role, the value of anamnesis and physical examination should be stressed as useful tools.

La apendicitis y su historia / Appendicitis and its history

Appendicitis is a common cause of acute abdominal pain. It is caused by the obstruction of the cecal lumen and can evolve to perforation and peritonitis. This article reviews the initial description and history of appendicitis and describes the signs and symptoms used for diagnosis. In today’s medicine, where technology plays an important role, the value of anamnesis and physical examination should be stressed as useful tools.