The Appendix

Initially viewed as a vestigial organ of little physiological significance, there has been an evolution of understanding about the roles the appendix may serve with respect to gastrointestinal immunoregulation and immunotolerance, as well as interactions with diseases related to disordered GI immunotolerance, such as ulcerative colitis. Emerging data related to medical and endoscopic therapies for appendicitis management has challenged the long-maintained belief that surgical intervention is the only appropriate option for management of this condition. Finally, a focused review of appendiceal neoplasia as it pertains to gastroenterology practice allows an opportunity to better hone disease recognition, understand therapeutic options including evolving endoscopic techniques, and examine the association between appendiceal neoplasia and traditional colorectal neoplasia to help provide a framework for future diagnostic and surveillance needs. In total, collective experience suggests that rather than a simple endoscopic afterthought, understanding the role of the appendix and associated diseases is an important component for any gastroenterologist's practice.