Ruptured appendix (vermiform appendage of cecum)

In some cases, inflammation of the appendix occurs. If a doctor does not treat this in a timely manner (within 24 to 72 hours), a patient will suffer a ruptured appendix. This situation is characterized by pain in the right lower abdomen, vomiting and diarrhea. This is followed by inflammation of the peritonium (peritonitis), which indicates a spread of the infection in the abdominal cavity. Peritonitis is characterized by extreme thirst and confusion, among other things. The doctor immediately removes the appendix, because left untreated a life-threatening condition arises from which a patient sometimes dies.

  • Appendix: Vermiform appendage of the cecum
  • Causes of inflammation and rupture of appendix
  • Symptoms
  • Signs of appendicitis
  • Typical signs of ruptured appendix
  • Atypical signs of ruptured appendix
  • Perititis
  • Treatment of ruptured appendix
  • Prognosis
  • Complications


Appendix: Vermiform appendage of the cecum

The large intestine consists of several parts, including the colon, the rectum, the anal canal, and the cecum (a small pouch located within the large intestine). The appendix is a finger-shaped tube about four inches long that is connected to the cecum. The function of the vermiform appendage of the cecum is unclear as of October 2020, but it may contain beneficial bacteria to recolonize the intestine after a serious infection. Other scientists think the appendix serves no useful purpose.

Causes of inflammation and rupture of appendix

When the appendix becomes infected, bacteria start to multiply. The appendix becomes inflamed and fills with pus, a thick fluid that contains bacteria, tissue debris, and dead white blood cells. This infection causes the pressure within the appendix to increase rapidly. As pressure increases, the amount of blood flowing through the wall of the organ decreases. The healthy cells that make up the tissues of the appendix then become starved and die. This continues until the muscle wall in one part of the appendix becomes so thin that it breaks open, causing the bacteria-filled pus to leak from the appendix into the rest of the abdomen.


Signs of appendicitis

Appendicitis is characterized by sharp pain that starts at the navel and is then felt in the lower right abdomen, where the appendix is located. The pain worsens with movement, deep breathing, coughing and sneezing.Other symptoms of appendicitis include:

  • vomit
  • constipation
  • diarrhea
  • an abdominal swelling
  • a loss of appetite
  • the inability to pass wind
  • nausea

The standard treatment for appendicitis is an appendectomy, a surgical procedure to remove the appendix .

Typical signs of ruptured appendix

If the appendix ruptures, the patient may feel better. The pain he originally had from the inflammation suddenly seems to have improved. However, this does not last long, as a perforated (ruptured) appendix quickly leads to other health problems. Pus-filled abscesses develop around the appendix. Scar tissue and other abdominal structures essentially close off the appendix and the pus from seeping through, preventing the infection from spreading. If the patient has an appendix with an abscess, the patient will have symptoms similar to appendicitis, including:

  • vomit
  • diarrhea
  • a lack of appetite
  • nausea
  • pain in the right lower abdomen


Atypical signs of ruptured appendix

The patient also sometimes experiences other symptoms not typically associated with appendicitis, such as weakness, chills, high fever, and a feeling of rectal fullness.


In addition, the infected contents that ooze from the appendix cause peritonitis. This is an infection of the peritoneum, the silky membrane that lines the abdominal cavity. The inflammation and pain then spread throughout the abdomen and worsen with any form of movement. Other symptoms of peritonitis include:

  • vomit
  • rapid breathing
  • a decreased appetite
  • extreme thirst
  • fever
  • urinating less than normal (oliguria) or not urinating at all (anuria)
  • nausea
  • chills
  • confusion


Treatment of ruptured appendix

In most cases, the doctor immediately removes the appendix (appendectomy) when peritonitis is present. He also cleans the inside of the abdomen to prevent an infection. Before an appendectomy, doctors sometimes treat the abscess or peritonitis with antibiotics, or else they drain the abscess (drain pus). If an abscess is present, there is a higher complication rate for surgery, so the doctor therefore tries to remove the abscess first if possible.


Without prompt or effective treatment, a ruptured appendix is a life-threatening condition. The outcomes are often bad. When a patient immediately knows the symptoms, immediately seeks medical attention and receives the correct diagnosis, he makes a full recovery from the ruptured appendix.


Occasionally a ruptured appendix leads to death. If the condition is left untreated, peritonitis spreads quickly, resulting in blood poisoning (sepsis) or bacteria in the blood. The body releases chemicals into the bloodstream to fight this infection, causing an inflammatory response throughout the body. A cascade of reactions ensues, ultimately resulting in septic shock, which causes severely low blood pressure and eventually leads to multiple organ failure and, in the worst cases, death.

read more

  • Appendectomy: Surgical removal of the appendix
  • Appendicitis: Inflammation of the appendix of the appendix
  • Peritonitis: Inflammation of the peritoneum due to infection in the abdominal cavity