Editing 2508: Circumappendiceal Somectomy

{{comic
| number    = 2508
| date      = August 27, 2021
| title     = Circumappendiceal Somectomy
| image     = circumappendiceal_somectomy.png
| titletext = Some personal news: After treating my first case a few years ago with antibiotics, I can report that I have now had appendicitis for the second and--unless something extremely unexpected happened with the surgery--final time.
}}

==Explanation==

In normal medicine, {{w|appendectomy}} is the surgical removal of an {{w|appendix}}. The purpose of the appendix is not fully understood, believed to be a reservoir for a human's gut microbiome. However if an appendix is swelling, it comes with risk of bursting and causing massive damage through internal bleeding and septic bacterial infection. In such cases the appendix may be partially removed through surgery.

Breaking down the comic's title: circum- means "around," -appendiceal means "the appendix," som(a)- means "the body," and -ectomy means "removal." Therefore, a circumappendiceal somectomy would be "a removal of the body from around the appendix." This appears to be the procedure that the doctor in the comic is describing.

The joke is that such a procedure is functionally identical to a typical appendectomy, the removal of the appendix from the body - just viewed from a different perspective. It humorously implies that the entire body of the patient is the problematic part to be removed, leaving the appendix behind.  It should be noted, though, that the procedure is identical only if it's done without disrupting the integrity of the body. There are situations in which an essential part is removed from a damaged or unimportant system by dismantling the system, piece by piece, leaving the part behind.  Obviously, this would not be an advisable method for treating {{w|appendicitis}}. {{Citation needed}}

The title text provides personal insight into the comic. It appears [[Randall]] has gotten appendicitis before, which may have been the inspiration of [[2147: Appendicitis]] and was treated using antibiotics instead of surgery. However, his appendix became inflamed again, and this time it was removed. Randall's experience is not uncommon, as a [https://pubmed.ncbi.nlm.nih.gov/32074268/ 2020 study] found that nearly 40% of patients treated with antibiotics for appendicitis required an appendectomy for recurrent appendicitis within 7 years. However, this should be the final time, as it is unlikely to get appendicitis without an appendix.{{Citation needed}} However, he does not rule out the possibility that something "extremely unexpected" happened during the surgery which could cause him to suffer from appendicitis again. Possible candidates for such an extremely unexpected event could include the surgeon faking the removal of Randall's appendix and leaving it intact, or removing only part of it, removing Randall's appendix but transplanting someone else's appendix into him instead, or even the appendix's [https://en.wikipedia.org/wiki/Regeneration_(biology) spontaneous regeneration].  While most of these possibilities are absurd, stump appendicitis, in which appendicitis occurs in remnant of the appendix that remains after surgery really does occur in 1 in 50,000 cases according to the article [https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1079652/ Appendicitis after appendicectomy - NCBI].

==Transcript==
:[Cueball is sitting with legs out over the edge of an examination table, hugging his stomach, likely because of stomach pains. A doctor in lab coat and a surgical head cap is standing next to the table speaking to Cueball, one arm stretched out towards him.]
:Doctor: Normally we would remove your appendix from your body.
:Doctor: But thanks to new surgical techniques, we're now able to remove your entire body from around your appendix!

{{comic discussion}}

[[Category:Comics featuring Cueball]]
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[[Category:Medicine]]