What Can Happen to Your Body if Your Appendix Suddenly Bursts?

If the appendix bursts, infection spreads in the abdomen (peritonitis) and can cause sepsis. It is a medical emergency, so go to the ER.

What happens

A burst (ruptured) appendix spills bacteria into the abdomen, causing peritonitis and possible sepsis and abscesses.

Risk

Rupture risk rises after 36 to 48 hours of symptoms.

Symptoms

Severe belly pain, fever, vomiting, rigid abdomen.

Treatment

Emergency surgery and IV antibiotics.

Outcome

Most recover with prompt care. Delay raises the risk of death.

Emergency

Call 911 for right-sided belly pain with fever.

Timeline and risk

An appendix usually ruptures 24 to 72 hours after symptoms begin. Appendicitis affects about 7 percent of people at some point, and about 5 to 20 percent of cases perforate, with higher rates in children under 5 and older adults, where diagnosis is often delayed.

• Rupture spills bacteria into the abdomen, causing peritonitis or an abscess.
• Pain may briefly ease after a rupture, then worsen with fever, rigid belly, rapid heartbeat and vomiting.
• Appendicitis is diagnosed with exam, blood tests (raised white cells) and ultrasound or CT.

Treatment and outlook

Treatment is an appendectomy (laparoscopic in most cases) with intravenous antibiotics. Perforated cases need longer antibiotics (4 to 7 days) and sometimes drainage of abscesses, with a hospital stay of several days. Most people recover fully in 2 to 4 weeks. Death is rare in modern care (under 1 in 1,000), but delay raises risk. Go to the emergency room for persistent abdominal pain that moves to the lower right side, with fever, vomiting or loss of appetite.

Timeline and risk

Appendicitis often progresses to rupture within 24 to 72 hours of symptom onset. Studies show about 20 percent of appendicitis cases are perforated at diagnosis, higher in young children. A rupture can cause peritonitis and abscess.

Treatment and outlook

Treatment is emergency surgery and antibiotics. Most people recover fully, though ruptured cases need longer hospital stays. Seek care for pain starting near the navel and moving to the lower right abdomen with fever and vomiting.

What happens in a rupture

A burst appendix (perforated appendicitis) spills bacteria and pus into the abdomen. It usually happens 48 to 72 hours after symptoms begin, and the risk of rupture rises after 36 hours. About 5 percent of Americans develop appendicitis, and roughly 20 percent of cases are perforated by the time of surgery.

Complications and treatment

Rupture can cause peritonitis, an abscess, sepsis and bowel obstruction. Pain may briefly ease and then become widespread with fever, rapid heartbeat and a rigid abdomen. This is an emergency. Treatment involves IV antibiotics, drainage of abscesses and surgery, often laparoscopic, with hospital stays of several days. Recovery takes 2 to 6 weeks. Seek care right away for right lower abdominal pain, nausea, fever and loss of appetite. Mortality is low with prompt treatment.

Based on data from the American College of Surgeons and the National Institutes of Health