The appendix is a finger-shaped tube that’s about four inches long and is connected to your cecum. It’s not clear what function your appendix has, but some scientists think it may help beneficial bacteria recolonize the gut after a severe infection. Other experts think the appendix serves no useful purpose. Whatever the case, removing the appendix through an appendectomy generally doesn’t cause any subsequent health problems. This condition, known as appendicitis, is marked by sharp pain that begins near the navel and then localizes over time to the lower right abdomen, where the appendix is located. The pain gets worse with movement, deep breaths, coughing, and sneezing. Other appendicitis symptoms include:
NauseaVomitingConstipationDiarrheaInability to pass gasLoss of appetiteFeverChillsAbdominal swelling
The standard treatment for appendicitis is an appendectomy, a surgical procedure to remove the appendix. But if doctors don’t remove the appendix quickly — usually within 24 to 72 hours after symptoms begin — the organ may rupture, or burst. (3) The result is a “perforated appendix.” It hasn’t popped like a balloon, but rather the appendix develops a small tear, which allows its contents to leak out into the rest of the abdomen and potentially cause other complications such as peritonitis, a severe inflammation of the intestinal lining, or a serious blood infection called septicemia. Perforation is found in about 13 to 20 percent of patients who have symptoms of appendicitis. (4) Children younger than 5 have a higher risk of perforation because they may not be able to describe and talk about their symptoms as clearly as older children and adults. (3) Your appendix becomes inflamed and filled with pus, a thick liquid containing bacteria, tissue debris, and dead white blood cells. This infection will cause the pressure within your appendix to quickly increase. As the pressure increases, the amount of blood flowing through the wall of the organ decreases. The healthy cells that make up the tissues of your appendix will then become starved of blood and start to die. (3) This will continue until the muscular wall in one area of your appendix gets so thin that it breaks open, allowing bacteria-laden pus from inside the appendix to leak out into the rest of the abdomen. But this generally doesn’t last long, because a perforated appendix can quickly lead to other health issues. Pus-filled abscesses may develop around your appendix. Scar tissue and other abdominal structures will “wall off” the abscessed appendix and the seepage, preventing the infection from spreading. A ruptured appendix can be a serious emergency and the patient should seek medical attention immediately. If you have an abscessed appendix, you may experience symptoms similar to appendicitis, including: (5)
Pain in your lower right abdomenDiarrheaLack of appetiteNauseaVomitingFeverChills
You may also experience other symptoms not typically associated with appendicitis, such as weakness, chills, high fever, and a feeling of rectal fullness. Additionally, the infected contents that have seeped out of your appendix may cause peritonitis, which is an infection of the peritoneum, the silk-like membrane that lines the abdominal cavity. (6) The inflammation and pain can spread throughout your abdomen, and become worse with any kind of movement. Other symptoms of peritonitis can include:
Decreased appetiteFeverNauseaExtreme thirstVomitingChillsConfusionRapid breathingUrinating less than normal or not at all
Doctors sometimes try to treat the abscess or peritonitis with antibiotics and drainage before conducting an appendectomy. When an abscess is present, there’s a higher complication rate with surgery, so your doctor may try to resolve the abscess first if possible. (3) Treatments usually involve draining any pus from the abdomen and fighting the infection with strong antibiotics for several weeks. (7) But some research suggests that immediately removing the ruptured appendix results in quicker recovery and fewer postoperative complications, particularly in children. A research review published in the Cochrane Database compared early versus delayed appendectomy in cases of complicated appendicitis. (8) The review authors note that it was unclear whether early appendectomy prevents complications when compared with delayed appendectomy in these kinds of patients. They concluded that more and better-quality data — concerning length of hospital stay and health-related quality of life outcomes — is needed to determine what benefits or harms there might be in early versus delayed appendectomy. A ruptured appendix can actually lead to death in some cases. If left untreated, peritonitis can quickly spread, resulting in septicemia, or bacteria in the blood. Your body releases chemicals into the bloodstream to fight this infection, triggering an inflammatory response throughout the body called sepsis. A cascade of reactions will follow, which can eventually lead to septic shock, which may cause severely low blood pressure and organ failure and death. Additional reporting by Deborah Shapiro.
