Burst Appendix: Survival Rate, Complications & symptoms, Doctor Explains.

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What is the incidence & survival rate of a burst appendix?

The incidence of burst appendix:

Burst appendix occurs in nearly one in every 5 cases of acute appendicitis (reference). No differences in the risk of burst appendix between males and females. However, the incidence of burst appendix was higher among young children and the elderly.

Another review study found that the risk of a burst appendix is about 13-20% of the cases of acute appendicitis (reference). Late diagnosis and delayed seeking for medical help increase the risk of a burst appendix.

Moreover, 3-7% of patients develop intestinal obstruction or paralytic ileus after perforated appendix surgery.

Here are some factors that increase the risk of perforation:

  • Young children.
  • Elderly debilitated patients.
  • Living in rural areas (leads to delayed access to medical help).

The survival rate of burst appendix:

The overall survival rate in cases of a burst appendix is very good. A large Swedish study found that the survival rate after a burst appendix surgery is about 99.5%. The death rate from a perforated appendix was 5.1 per 1000 cases.

The burst appendix survival rate is lower than non-complicated appendicitis. The death rate from non-complicated appendicitis was only 0.8 per 1000 cases.

What causes an appendix to burst?

The following are the leading factors of rupture appendix:

  • Time (delayed diagnosis and treatment of acute appendicitis).
  • Appendix obstruction (be a hard stool, stone, or swollen lymphatics).
  • Appendix infection (bacteria build-up inside the appendix).
  • Appendix gangrene (obstruction of the blood supply of the appendix leads to necrosis (death) of its wall).
  • Others such as pain control medications which delay the diagnosis, dementia, and psychiatric/mental diseases.

Learn More: What causes the appendix to burst? Doctor explains.

Burst appendix Vs non-complicated appendicitis (symptoms & differences).

1 . Initial (temporary) pain relief.

Perforation probably occurs due to mucus and bacterial build-up inside an obstructed appendix. Just before the perforation, the pressure and pain are at their maximum.

Rupture of the appendix relieves this pressure for a short period. That’s why the feeling of temporary relief for minutes or a few hours can be a sign of a burst appendix.

2. Severe, diffuse abdominal pain.

After the temporary pain relief, the pain reappears again. This time, the pain is often more extreme with severe tenderness and rigidity over your belly.

Unlike the typical appendicitis pain location (right iliac or around the umbilicus), The pain from a burst appendix is diffuse all over your abdomen.-

3. Fever (high-grade).

Fever occurs in 40% of patients with appendicitis. The fever is often low grade in patients with a non-perforated appendix,

One study found that a high-grade fever (often more than 39.5°C or 103° F) is a strong indicator of appendix perforation.

4. Symptoms of complications.

A. Peritonitis.

Perforation of the appendix spreads the pus and the bacteria into the peritoneal cavity. The peritoneum is a thin double-layered membrane that covers your abdominal organs and the intestine.

The presence of bacteria and pus inside the peritoneum leads to its inflammation (called peritonitis).

Peritonitis is responsible for severe diffuse abdominal pain, tenderness, and rigidity.

B. Sepsis and septic shock.

Moreover, The bacteria and their toxins can pass into your bloodstream. The presence of bacterial toxins is called (sepsis).

Sepsis is a serious complication of a burst appendix which can lead to serious consequences such as:

  • Low blood pressure (septic shock).
  • Fast heartbeats.
  • Shallow breathing.
  • Dizziness, confusion, or loss of consciousness.

How does your doctor diagnose a burst appendix?

your doctor often performs laboratory and imaging studies to diagnose such conditions. However, the final confirmation of the perforation is often during the operation.

Your doctor can suspect a burst appendix  based on the following signs and tests:

  • A Fast heart rate > 90 beats per minute.
  • The presence of fluid collection around the appendix in abdominal ultrasonography, CT, or MRI.
  • A White blood cell count >15,000.
  • Low blood pressure.
  • weak rapid pulse.