Acute Appendicitis

This chapter provides a summary of a landmark historical study in surgery involving management and treatment of acute appendicitis. It describes the history of the disease, gives a summary of the study including study design and results, and relates the study to a modern-day principle of evidence-based medicine: observational studies in study design. Reginald H. Fitz’s insights over a century ago in a seminal case series regarding the nature of appendicitis, its potential sequelae, and the value of urgent surgical intervention changed the disease from a deadly one into one that can be easily cured by surgery. However, with the advent of modern broad spectrum antibiotic therapy, Fitz’s assertion that immediate surgical therapy is always mandated has recently come under question.