The appendix is a small, finger-shaped pouch attached to the first part of the large intestine called the cecum. The exact purpose of the appendix is unknown, but it contains lymphoid tissue that is part of the immune system. When the appendix becomes inflamed, a condition called appendicitis develops. If appendicitis is not treated, the appendix can rupture or burst. This is a medical emergency that requires prompt surgery to remove the burst appendix. If you don’t realize your appendix has burst, it can have potentially life-threatening complications.
What are the symptoms of a burst appendix?
The typical symptoms of appendicitis include:
- Pain that starts around the navel and then shifts to the lower right abdomen
- Loss of appetite
- Nausea and vomiting
- Fever
- Constipation or diarrhea
When the appendix bursts, symptoms tend to get worse, including:
- Severe pain in the right lower abdomen
- Increased pain with coughing, walking, or other jarring movements
- Fever greater than 101°F (38.3°C)
- Inability to pass gas
- Abdominal swelling
- Increased heart rate
However, some people may have an unusual presentation without many of the typical symptoms when their appendix ruptures. For example, the elderly, young children, and people with suppressed immune systems may have milder symptoms.
What happens when a burst appendix goes untreated?
When the appendix bursts, digestive juices and bacteria leak into the abdomen. This causes an inflammatory reaction called peritonitis. At first, the abdomen responds by walling off the infection. This leads to formation of an abscess, which is a pocket of pus surrounded by inflamed tissue.
If the body cannot control the spread of infection, peritonitis can quickly spread throughout the abdomen. This is life-threatening and requires emergency surgery.
Some potential complications of an untreated burst appendix include:
- Sepsis – A systemic blood infection that can lead to organ failure and death.
- Perforation – Holes that form in the intestines due to enzymes dissolving tissue.
- Bowel obstruction – Scar tissue can cause total or partial blockage of the intestines.
- Abscesses in the pelvis, liver, or other areas.
Even if abscesses are successfully drained, they may keep returning in the future.
How is a burst appendix diagnosed?
A doctor will start by asking about your symptoms and performing a physical exam to check for signs of appendicitis. They will pay close attention to your abdomen, checking for tenderness, swelling, and muscle tension.
Tests that can help confirm a burst appendix include:
- Blood tests to check white blood cell count – High levels usually indicate infection.
- Urine test – There may be signs of infection if the bladder has been affected.
- Pregnancy test for women of childbearing age – To determine if pain could be pregnancy-related.
- CT scan – Can visualize abscesses and confirm that the appendix has ruptured.
- Ultrasound – May be done first in children and pregnant women to avoid radiation.
- MRI – Provides clear images of soft tissues and can distinguish abscesses.
Your doctor will order the tests appropriate for your symptoms and health history. Prompt evaluation and diagnosis of a burst appendix can help prevent further complications.
What is the treatment for a burst appendix?
Surgery is needed right away if your appendix has ruptured. The surgeon will make a few small incisions in the abdomen, insert a camera, and surgically remove the appendix. This is called a laparoscopic appendectomy. The abdominal cavity will be washed out to remove infectious materials.
If an abscess has formed, it may need to be drained first before the appendectomy. The surgeon may decide to do the appendectomy during a second operation once the infection clears up.
After surgery, antibiotics will be prescribed to treat infection. Further treatment depends on how much the appendix burst and spread bacteria. Your recovery time in the hospital will vary based on complications.
How can a burst appendix be prevented?
It’s not always possible to prevent a burst appendix. But getting medical attention quickly when appendicitis symptoms start can prevent it from rupturing.
You should go to the emergency room or call your doctor right away if you notice any symptoms of appendicitis. Be aware that pain may begin around the navel before localizing to the lower right abdomen. Getting examined within the first day of symptoms provides the best chance for a positive outcome.
Some tips for preventing a burst appendix:
- Seek treatment at the first sign of appendicitis symptoms.
- Follow your doctor’s instructions if treated for early appendicitis.
- Don’t wait for pain to get debilitating before going to the ER.
- Get regular health check-ups to identify any problems early.
- Lead a healthy lifestyle with good diet and exercise habits.
While appendicitis can’t always be avoided, prompt treatment greatly lowers the likelihood of rupture. Listen to your body and contact a doctor if you suspect a problem.
Conclusion
A burst appendix is a medical emergency requiring urgent surgery. Left untreated, it can lead to dangerous infections and complications, including abscesses, peritonitis, sepsis, and death in severe cases. Seek immediate medical care if you experience severe abdominal pain that continues to get worse, especially if accompanied by fever, vomiting, and swelling. Early diagnosis and appendectomy offer the best outcomes for this potentially life-threatening condition. Stay vigilant about any new or worsening abdominal symptoms and get them evaluated promptly.