Appendix Rupture Causes and Symptoms

How to know your appendix burst and what happens if it does

Table of Contents
View All
Table of Contents

A ruptured appendix is a serious medical emergency that can happen when appendicitis goes untreated. Inflammation in the organ leads to swelling and pus build-up that cause the appendix to tear or "burst" within days. This spreads bacteria throughout your abdomen.

A burst appendix can cause a painful, life-threatening infection. Immediate surgery to remove the appendix and wash the abdominal cavity is necessary.

This article explains what happens with an appendix ruptures, how to tell if this may have happened to you, and what healthcare providers can do to treat it.

Patient with a ruptured appendix

Thitaree Mahawong / EyeEm / Getty Images

What Causes an Appendix Rupture?

A ruptured appendix is a complication of appendicitis, an inflammation of the appendix. Left untreated, the inflammation can cause the appendix to swell and become filled with pus. This is what causes the appendix to rupture or tear.

The contents then leak into the abdomen, which spreads the infection.

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

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 experience an appendix rupture.

How Do You Know Your Appendix Burst?

When your appendix ruptures, symptoms may include:

  • Lower-right abdominal pain that lessens and then returns in a more severe form
  • Pain 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.

Symptoms of an appendix rupture typically appear within 48 to 72 hours after you begin having symptoms of appendicitis. This is why it's critical that you seek medical attention right away if you have appendicitis symptoms.

Symptoms of Appendicitis

Appendicitis pain usually begins near your belly button and spreads to the right side of your lower abdomen, where your appendix is, as it worsens. The pain can also start there.

Pain usually worsens when moving, breathing deeply, coughing, or sneezing. You may also feel pain when the area is lightly pressed.

In addition to pain, appendicitis can cause:

Seek Care Right Away

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.

How a Ruptured Appendix Is Treated

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

This may be done in one of two ways:

  • Laparoscopically with a small incision and use of a lighted tube and camera to see inside the body
  • As an open surgery (laparotomy) using a larger incision to clean out the infection that leaked into the abdomen

In some cases, appendicitis leads to a pocket of pus (abscess). If this happens, your healthcare provider will need to drain the the abscess before your appendix can be removed. This procedure is done while you are sedated. You are then given antibiotics for a period of time before your appendectomy.

After the surgery, you will receive IV (intravenous) antibiotics to eradicate any remaining infection. You will also be given antibiotic pills to take when you get home. It's important that you take all the medication as directed by your healthcare provider.

Can You Survive a Burst Appendix?

Most people survive a burst appendix, as long as they receive immediate emergency care. Still, the mortality rate for appendicitis with a ruptured appendix is around 5%, compared to less than 1% for appendicitis without a rupture.

The bacteria released into the abdomen when an appendix bursts 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.

Other Potential Complications

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


Currently, there is no known way to prevent appendicitis. However, if you notice appendicitis 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.


A ruptured appendix is when the appendix (the small tube at the end of the large intestine) tears. This leaks bacteria into the abdomen that can cause a life-threatening infection. This is a medical emergency and surgical removal of the appendix is necessary.

If you have severe abdominal pain that goes way but comes back even stronger, particularly if it's in the lower-right abdomen, call 911 or go to the emergency room.

If you have severe pain near your belly button that moves to the lower right side of your abdomen, you may have caught appendicitis before it progressed to an appendix rupture. Call your healthcare provider without delay.

12 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.
  1. Johns Hopkins Medicine. Appendectomy.

  2. National Health Service. Complications appendicitis.

  3. National Institute of Diabetes and Digestive and Kidney Diseases. Symptoms and causes of appendicitis.

  4. Johns Hopkins Medicine. Appendicitis.

  5. Lastunen K, Leppäniemi A, Mentula P. Perforation rate after a diagnosis of uncomplicated appendicitis on CT. BJS Open. 2021;5(1):zraa034. doi:10.1093/bjsopen/zraa034

  6. National Library of Medicine. Appendectomy.

  7. National Institute of Diabetes and Digestive and Kidney Diseases. Treatment for appendicitis.

  8. Seif, HMA, Hesham A, Korany M, Metwally M, Ahmed A. Immediate operation versus percutaneous drainage for treatment of appendicular abscess. Egypt J Radiol Nucl Med. 2015;46(4):999-1002. doi:10.1016/j.ejrnm.2015.06.010

  9. van den Boom AL, de Wijkerslooth EML, Wijnhoven BPL. Systematic review and meta-analysis of postoperative antibiotics for patients with a complex appendicitis. DSU. 2020;37(2):101-110. doi:10.1159/000497482

  10. Dogra BB. Acute appendicitis: common surgical emergency. Med J DY Patil Univ. 2014;7:749-52 doi:10.4103/0975-2870.144866

  11. National Library of Medicine. Peritonitis.

  12. National Institute for Diabetes and Digestive and Kidney Diseases. Appendicitis.

By Nancy LeBrun
In addition to her extensive health and wellness writing, Nancy has written about many general interest topics for publications as diverse as Newsweek, Teen Vogue,, and Craftsmanship Quarterly. She has authored a book about documentary filmmaking, a screenplay about a lost civil rights hero, and ghostwritten several memoirs.