Appendicitis: it nearly killed King Edward VII

How would you like to be the young surgeon in 1902 who was asked to see Prince Edward who was to be crowned King of England in two days? His Mother, Queen Victoria, had reigned so long that Edward had become the playboy prince. Now he was obese, old, flatulent and a terrible operative risk. Young Dr. Treves diagnosed a ruptured appendix and recommended surgery, much to the consternation of other doctors.

While Treves operated, officials were preparing for the king’s funeral. But Treves got lucky. His decision proved prudent. He simply drained an abscess and left the appendix alone. No doubt Treves also lifted more than one prayer to the Almighty. Luckily, Edward survived and was later crowned King Edward VII of England. Treves was knighted for his efforts.

A report from the Canadian Medical Protective Association shows that it’s not only kings that develop a ruptured appendix. Some form an abscess and kill patients. Others do not.

This year about 250,000 appendectomies will be done in North America. Fortunately, it’s rare today to die from uncomplicated appendicitis. But when trouble strikes, the cause is usually a delay in diagnosis and treatment.

A typical attack of appendicitis starts with abdominal pain. But contrary to what most people think, it doesn’t begin in the right side. Rather, it starts in the upper part of the abdomen. Sometimes it’s only a nagging discomfort. But at other times it can be associated with severe pain along with nausea and vomiting.

After several hours the pain finally gravitates to the lower right side. This soreness is apt to be increased by coughing or any other jolt. Normally, there is also a slight elevation of temperature. The great problem is that this textbook description of appendicitis doesn’t always happen.

The Canadian Medical Protective Association report outlines common problems that can trigger complications. For example, one patient complained of abdominal pain lasting two days, along with nausea and vomiting. But the doctor believed the abdominal discomfort was related to sore muscles due to strain of vomiting. She was discharged with a diagnosis of gastroenteritis. But then in this case, and frequently in others, a big mistake occurred. The patient was not provided with adequate information of what to do if symptoms failed to subside.

Several days later the patient’s condition deteriorated and she was seen in the emergency department. This time the diagnosis was a ruptured appendix with abscess. But now the patient also required removal of part of the large and small bowel. What could have been a simple appendectomy had turned into a major procedure.

In another case, a grossly overweight patient with vague abdominal complaints was sent home and advised to return if fever, vomiting or the pain became worse. A few days later a CT scan diagnosed appendicitis and surgery was performed with a happy outcome. But obesity always makes the diagnosis more difficult and complications more likely. But not in this case.

Today more cases of appendicitis are being diagnosed by either CT scans or ultrasound. In addition, some appendectomies are being performed by laparoscopy, resulting in a shortened post-operative recovery.

Can the King Edward disease be prevented? Appendicitis is virtually unknown in Kenya, Uganda, Egypt and India where people eat a high fiber diet. And during the second world war, when the Swiss were forced to consume less refined sugar and more fiber, their rate of appendicitis dropped.

It’s interesting how the surgical treatment of appendectomy has changed over the years. The great French surgeon, Dupuytren, ridiculed the notion that it was impossible for such a small organ to produce such disastrous results.

Others disagreed with him. In 1855 one surgeon, Henry Sands of New York, merely stitched up the perforated hole in an appendix. He then returned the appendix to the abdomen and the patient survived. More due to the grace of the Almighty than sound surgical judgment, it seems.

Remember, if you have abdominal pain don’t delay in seeking attention. Never, never take a laxative to ease the pain and don’t eat or drink. Both can cause trouble if surgery is needed.

See the web site www.docgiff.com. For comments info@docgiff.com.

Just Posted

Ignition Theatre delves into Gruesome Playground Injuries

Compelling production runs through to Jan. 26th in the Nickle Studio

First official speed skating competition held at Setters Place this weekend

More than 100 junior speed skaters from across Alberta competed in the Jeremy Wotherspoon Open

Get your healthy on

Healthy Living Expo promotes sustainable, innovative and healthy lifestyles

WATCH: Team Alberta visits Red Deer this weekend to prepare for Canada Winter Games

About 250 Team Alberta athletes toured venues and tested out facilities Saturday

Keep focus on helping Canadians at home, Trudeau tells MPs at start of meeting

Trudeau said the Liberals will offer Canadians hope amid issue like climate change and global tensions

World economy forecast to slow in 2019 amid trade tensions

For Canada, the IMF’s estimate for growth in 2019 was 1.9 per cent, down from expected global growth of 3.5 per cent

2-for-1: Total lunar eclipse comes with supermoon bonus

On Sunday night, the moon, Earth and sun lined up to create the eclipse, which was visible throughout North and South America

‘Gotti’ leads Razzie nominations, Trump up for worst actor

The nominations were announced on Monday, Jan. 21 with some movies earning up to six nominations

PHOTO: Eyes turn to heavens to witness super blood wolf moon

These two photos show the lunar eclipse about 30 minutes apart from each other.

Skaters stranded in Saint John, NB, amid storm on last day of championships

More than half of the flights out of the city’s airport were cancelled due to the weather

Call for tighter bail rules after Saudi sex-crime suspect vanishes

Mohammed Zuraibi Alzoabi was facing charges related to alleged sexual assault, criminal harassment, assault and forcible confinement of a woman

May plans next move in Brexit fight as chances rise of delay

Some say a lack of action could trigger a ‘public tsunami’

Group challenges ruling for doctors to give referrals for services that clash with beliefs

A group of five Canadian doctors and three professional organizations is appealing

Most Read