Ruptured Appendix: Everything You Need to Know

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The appendix is a small tube at the end of the large intestine. Its function is not entirely known, but it's suspected that it acts as part of the immune system, a "holding tank" for good gut bacteria. A person doesn't need their appendix to be healthy; however, if it becomes swollen and inflamed, it becomes appendicitis. If it ruptures, it can be life-threatening.

Read on to learn how to recognize the symptoms of a ruptured appendix, what to do if you think you might have one, and how it's treated.

Patient with abdominal pain, ruptured appendix

Thitaree Mahawong / EyeEm / Getty Images

Ruptured Appendix Causes

A ruptured appendix is a complication of appendicitis, an inflammation of the appendix.

The causes of appendicitis aren't completely understood, but experts think they include:

  • Infection in the digestive tract
  • Feces that harden and block the appendix
  • Inflammatory bowel disease (IBD)

If the inflammation isn't treated, the appendix can swell and become filled with pus, making the lining rupture or tear. The contents then leak into the abdomen, which spreads the infection.

How Common Is a Ruptured Appendix?

About 1 in 1,000 people in the U.S. develop appendicitis. One study of people diagnosed with appendicitis found that 22.3% of those people developed a burst appendix.

Signs of a Ruptured Appendix

The typical first sign of appendicitis, which can lead to a ruptured appendix, is pain near your belly button. If it gets worse and spreads to the right side of your lower abdomen, that's the next indication. It can also start in the right side of your lower abdomen, where your appendix is located.

You may also experience:

  • Diarrhea
  • Constipation
  • Low fever
  • Nausea or vomiting
  • Lack of appetite
  • Pain that worsens when moving, breathing deeply, coughing, or sneezing
  • Pain when the area is lightly pressed

Signs of a ruptured appendix include:

  • Pain lessens and then returns in a more severe form
  • Pain is all over your abdomen

The pain may go away for a few hours because the rupture releases pressure, but serious infection can set in quickly. A rupture can happen within two to three days after the pain starts.

When to See a Healthcare Provider

Appendicitis can become a serious medical emergency quickly. If you have pain near your belly button that moves down to a lower part of your stomach on the right side, call your healthcare provider immediately, go to the emergency room, or call 911.

Treatment

If your appendix ruptures, you need emergency surgery called an appendectomy to remove it.

Healthcare providers may be able to make a small incision and perform surgery with a lighted tube and camera, called a laparoscopy (or laparoscopic surgery). Often, they will need to make a larger incision, called a laparotomy, for an open surgery to clean out the infection that leaked into the abdomen.

After the surgery, you will be given antibiotics to eradicate any remaining infection. Your healthcare provider will give you antibiotics through an IV (intravenous) line into a vein in your arm. They will also give you antibiotic pills to take when you get home. It's important that you take all the medication as directed by your healthcare provider.

In some cases, appendicitis leads to an abscess, which is a pocket of pus. The abscess will need to drain before you can have surgery. Healthcare providers can do this with a procedure while you're sedated, and then give you antibiotics for a period of time before your appendectomy.

Complications

When an appendix bursts, it releases bacteria into the abdomen. That may cause peritonitis, an infection of the lining of your abdomen, which can be fatal.

There is also a risk of sepsis, a life-threatening infection in the bloodstream.

Surgical complications from an appendectomy are uncommon, but may include:

  • Infection
  • Abscess
  • Fistula, or abnormal passage, between your abdominal organs and skin
  • Small bowel obstruction
  • Ileus (a condition in which the bowel does not contract normally)
  • Adhesions, or scar-like tissue, inside your stomach

Prevention

Currently, there is no known way to prevent appendicitis. However, if you notice symptoms, you can prevent them from becoming more severe by contacting your healthcare provider or going to the emergency room right immediately.

Appendectomies, whether the appendix has burst or not, are generally considered emergency surgeries.

Summary

A ruptured appendix is when the appendix (the small tube at the end of the large intestine) tears. It is a medical emergency. Call your healthcare provider immediately if you have severe pain near your belly button, which moves to the lower right side of your abdomen.

If the pain goes away but comes back and hurts even more, your appendix may have ruptured. In that case, call 911 or go to the emergency room. Don't ignore symptoms of appendicitis. Surgical removal of your appendix is a relatively simple surgery if the appendix has not ruptured.

A Word From Verywell

We all get stomach pain sometimes, but being alert to unusual kinds of pain that can get very serious very quickly is important. If you have pain near your belly button, pay attention to it and monitor if it moves down or goes away and comes back. If it does, don't waste time—go to the emergency room or call 911 right away. Surgery can save your life.

Frequently Asked Questions

  • Is a ruptured appendix life-threatening?

    A ruptured appendix can be life-threatening when bacteria from the rupture spreads into the abdomen or gets into the bloodstream. Surgery and antibiotics can treat a ruptured appendix, but it must be done quickly.

  • How painful is a ruptured appendix?

    Appendicitis, which can lead to a ruptured appendix, is a very sharp pain that appears suddenly. It may get worse if you cough or when you move. If it goes away and comes back and is even worse, the appendix may have ruptured.

  • What are the early warning signs of appendicitis?

    Appendicitis symptoms can be similar to other conditions that cause abdominal pain. Watch for pain near your belly button or on the lower right side of your abdomen, where your appendix is located.

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11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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