My Kepler Bb humanoids have lots of similarities to us and lots of differences too. Here are some of those differences: Extra intracranial space so that the brain can swell from illness without injuring itself Appendix actively participates in digestion by breaking cellulose down into simple sugars that are then absorbed into the blood(so longer appendix) 2 hearts and circulatory systems, 1 of which is inverted 2 sets of ovaries in females Now, there is a virus that can be transmitted in every way possible, is completely antiviral resistant, and can infect every part of the body. That virus causes a severe and sometimes even deadly illness known as Viral TB. Viral because a virus infects the cells and TB because it can infect every part of the body and granulomas regularly form and go away(latent and active phases respectively). This can be a serious problem if the virus infects the appendix causing appendicitis. Appendicitis caused by Viral TB actually has 2 stages that are determined by the phase of the virus in the appendix. The first stage of appendicitis is actually pretty mild. Swelling occurs but blood supply stays normal for the appendix. This also corresponds with colitis and proctitis in the timing(colitis at the same time as appendicitis, proctitis a bit later than appendicitis. This is when the virus is in the active phase in the appendix. But later on when the immune system traps the virus in granulomas, it is quite different. At this point the appendix is blocked by granulomas which leads to a much more severe stage of appendicitis and even a ruptured appendix. Because the appendix is blocked the mucus and gut flora can't get to the colon and food with cellulose can't get to the appendix. The appendicular artery starts to get pinched by the appendix and this is when classic symptoms of appendicitis appear such as RLQ pain. As the appendicular artery gets pinched, the appendix starts to die. Not a good thing. But it gets worse. As the appendix dies, the wall weakens and eventually it ruptures causing an infection throughout the abdomen. All from an organ the width of a finger. Because it is caused by a virus, antibiotics won't work. And antivirals won't work because the virus is completely resistant to them. So there are really only 2 options here. Option 1: Appendectomy 1 option is to have the appendix removed either via open surgery or laproscopically. This will prevent the humanoid from ever getting appendicitis again but with the cost of not getting as much energy from food as previously(which would be bad news for vegetarians) Option 2: Drainage via colonoscopy The other option is to have a drain put into the appendix via colonoscopy so that mucus and gut flora can go from the inflamed appendix to the colon. Again, this means that the humanoid would not get as much energy from food but this is only a cost during the appendicitis. After it is over, the drain is taken out of the appendix via colonoscopy and the appendix can participate in digesting food again. But this has the risk of reoccurring appendicitis. So I was thinking that appendectomy should only be a last resort given the importance of the appendix and should only be done if the appendix ruptures. So appendix drainage via colonoscopy would be the preferred way to go about treating any appendicitis really and the drain would be in there for a few days or weeks if the appendicitis isn't caused by Viral TB and months to years if it is. But is it reasonable to put a drain into the appendix in humanoids with appendicitis to prevent rupture of the appendix due to its role in digestion or should everyone, including vegetarians get an appendectomy and just eat more food to compensate for a removed appendix?