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Appendicitis or Ruptured Appendix Survivors

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Alexander, Beck, Ciminella, Cooper and 6 others
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Please add the profiles of those who have survived Appendicitis or a Ruptured Appendix.

If they died of Appendicitis or a Ruptured Appendix, please add them to the People who died from Appendicitis project.

Appendicitis is an inflammation of the appendix, a 3 1/2-inch-long tube of tissue that extends from the large intestine. It is a medical emergency that almost always requires prompt surgery to remove the appendix. Left untreated, an inflamed appendix will eventually burst, or perforate, spilling infectious materials into the abdominal cavity. This can lead to peritonitis, a serious inflammation of the abdominal cavity's lining (the peritoneum) that can be fatal unless it is treated quickly with strong antibiotics

Sometimes a pus-filled abscess (infection that is walled off from the rest of the body) forms outside the inflamed appendix. Scar tissue then "walls off" the appendix from the rest of the abdomen, preventing infection from spreading. An abscessed appendix can perforate or explode and cause peritonitis. For this reason, almost all cases of appendicitis are treated as emergencies, requiring surgery.

In the U.S., one in 20 people will get appendicitis. Although it can strike at any age, appendicitis is rare under age 2 and most common between ages 10 and 30.

What causes appendicitis?

  • Appendicitis occurs when the appendix becomes blocked, often by stool, a foreign body, or cancer.
  • Blockage may also occur from infection, since the appendix can swell in response to any infection in the body. The bacteria multiply rapidly, causing the appendix to become inflamed, swollen and filled with pus. If not treated promptly, the appendix can rupture.

What Are the Symptoms of Appendicitis?

  • The classic symptoms of appendicitis include:
    • Dull pain near the navel or the upper abdomen that becomes sharp as it moves to the lower right abdomen. This is usually the first sign.
      • The site of pain may vary, depending on age and the position of the appendix.
      • In pregnancy, the pain may seem to come from the upper abdomen because the appendix is higher during pregnancy.
    • Loss of appetite
    • Nausea and/or vomiting soon after abdominal pain begins
    • Abdominal swelling
    • Fever of 99-102 degrees Fahrenheit
    • Inability to pass gas
  • Almost half the time, other symptoms of appendicitis appear, including:
    • Dull or sharp pain anywhere in the upper or lower abdomen, back, or rectum
    • Painful urination and difficulty passing urine
    • Vomiting that precedes the abdominal pain
    • Severe cramps
    • Constipation or diarrhea with gas

When to seek medical attention:

  • If you have pain or tenderness in the right abdomen and any of the other mentioned symptoms that seem to persist or worsen, especially the abdominal pain, seek medical attention immediately, because timely diagnosis and treatment is very important.
    • Do not eat, drink, or use any pain remedies, antacids, laxatives, or heating pads, which can cause an inflamed appendix to rupture.

Complications can include:

  • A ruptured appendix. A rupture spreads infection throughout your abdomen (peritonitis). Possibly life-threatening, this condition requires immediate surgery to remove the appendix and clean your abdominal cavity.
    • Perforation of the appendix with a pocket of pus forming in the abdomen. If the appendix bursts, the infection can spread throughout the abdomen (diffuse peritonitis--infection of the entire lining of the abdomen & pelvis). However, it is usually confined to a small area where a pocket of infection (abscess) surrounding the appendix may develop. The cause of such a rupture is unclear, but it may relate to changes that occur in the lymphatic tissue that lines the wall of the appendix. In most cases, a surgeon drains the abscess by placing a tube through the abdominal wall into the abscess. The tube is left in place for two weeks, and antibiotics are given to clear the infection.
    • Once the infection is clear, you'll have surgery to remove the appendix. In some cases, the abscess is drained, and the appendix is removed immediately.
  • Blockage or obstruction of the intestine is less common. It occurs when the inflammation surrounding the appendix compresses the intestine which prevents the intestinal contents from passing. If the intestine above the blockage begins to fill with liquid and gas, the abdomen distends, and greater nausea and vomiting may occur. It then may be necessary to drain the contents of the intestine through a tube passed through the nose and esophagus and into the stomach and intestine.
  • Sepsis is a feared complication of appendicitis, It is a condition in which infecting bacteria enter the blood and travel to other parts of the body. This is a very serious, even life-threatening complication. Fortunately, it occurs infrequently.
  • During pregnancy, acute appendicitis is the most common non-obstetric emergency requiring surgery. It occurs at the same rate in women who are and aren’t pregnant.
    • When it does occur in pregnant women, it’s usually during the second or third trimester. Its symptoms can often be mistaken for routine discomfort associated with pregnancy, making diagnosis difficult. However, treatment is the same as for women who aren’t pregnant.
  • Sometimes, the body is successful in containing ("healing") the appendicitis without surgical treatment if the infection and accompanying inflammation cause the appendix to rupture. The inflammation, pain, and symptoms also may disappear when antibiotics are used. This is particularly true in elderly patients. Patients then may come to the doctor long after the episode of appendicitis with a lump or a mass in the right lower abdomen that is due to the scarring that occurs during healing. This lump might raise the suspicion of cancer.

Diagnosis can include, but is not limited to the following:

There is no one test that will diagnose appendicitis with certainty. Therefore, the approach to suspected appendicitis may include a period of observation, during which the following will occur, or surgery.

  • Obtain a thorough History of symptoms
  • Physical exam -- looking especially for right lower quadrant abdominal pain or tenderness or rebound tenderness
  • Pelvic exam (for females) -- to rule out possible reproductive problems or other pelvic infections
  • Lab work -- CBC (= complete blood count), urinalysis, pregnancy test for females to rule out ectopic pregnancy, other possible blood work
  • Chest x-ray -- to rule out right lower lobe pneumonia as it sometime has similar symptoms
  • Abdominal imaging that can include abdominal x-ray, barium enema x-ray, ultrasound or CT scan to determine if there is an abscess or other complication, and rule out other intestinal problems that mimic appendicitis, such as Crohn’s disease.
  • Surgeons can also do laparoscopy to explore the abdominal cavity and help determine the diagnosis.

Why can it be difficult to diagnose appendicitis?

Difficulty in diagnosing appendicitis is due to the varied position of the appendix in the abdomen. Most of the time the appendix is in the right lower abdomen, but the appendix, like other parts of the intestine, has a mesentery. This mesentery is a sheet-like membrane that attaches the appendix to other structures within the abdomen. If the mesentery is large, it allows the appendix to move around. In addition, the appendix may be longer than normal. The combination of a large mesentery and a long appendix allows the appendix to dip down into the pelvis (among the pelvic organs in women). It also may allow the appendix to move behind the colon (called a retro-colic appendix). In either case, inflammation of the appendix may appear to be more like the inflammation of other organs, for example, of a woman's pelvic organs such as a result of ectopic pregnancy or pelvic inflammatory disease (PID).

The diagnosis of appendicitis also can be difficult because other inflammatory problems may mimic appendicitis, for example, right side diverticulitis, some kidney diseases, and inflammatory disease of the right upper abdomen. Therefore, it is common to observe patients with suspected appendicitis for a period of time to see if the problem will resolve on its own or develop characteristics that more strongly suggest appendicitis or, perhaps, another condition.

Treatment for appendicitis varies. In most cases, however, surgery will be necessary. The type of surgery will depend on the details of the individual’s case.

If an abscess hasn’t ruptured, the doctor may first administer antibiotics and drain the abscess using a tube placed through your skin. After receiving this treatment for the infection, surgery to remove the appendix will occur.

Prognosis:

With an early operation, the chance of death from appendicitis is very low. The person can usually leave the hospital in 1 to 3 days, and recovery is normally quick and complete. However, older people often take longer to recover.

Without surgery or antibiotics (as might occur in a person in a remote location without access to modern medical care), more than 50% of people with appendicitis die.

For a ruptured appendix, the prognosis is more serious. Decades ago, a rupture was often fatal. Surgery and antibiotics have lowered the death rate to nearly zero, but repeated operations and a long recovery may be necessary.

History:

  1. Columbia University, Dept. of Surgery - General Surgery - “History of Medicine: the Mysterious Appendix”
  2. NCBI - History of surgical treatment of appendicitis. 2009
  3. History of Appendicitis Vermiformis, Its Disease & Treatment. by Arthur C McCarty, MD
  4. Annals of Surgery, Vol 197, May 1983, No. 5. Presidential Address: A History of Appendicitis by: G Rainey Williams, MD
  5. Hektoen International, A Journal of Medical Humanities - The Early Days in the history of Appendectomy, by Damiano Rondelli, (Summer 2013)

Since its debut in the annals of medical literature, the appendix has always held some mystery. In the 1500s, anatomists were able to identify its structure within the body, but could only guess at its purpose. Jacopo Berengario da Carpi gave the first description of this structure in 1522. Gabriele Fallopio, in 1561, appears to have been the first writer to compare the appendix to a worm. In1579 Caspar Bauhin proposed the ingenious theory that the appendix served in intrauterine life as a receptacle for the faexes. However, doctors did recognize that it could become inflamed and cause serious disease.

In 1735, Dr. Claudius Amyand performed the world’s first successful appendectomy, at St. George’s Hospital in London. The patient was an 11-year old boy whose appendix had become perforated by a pin he had swallowed. The first successful operation to treat acute appendicitis was performed soon after, in 1759 in Bordeaux.  General anesthesia was not available until 1846, so these operations required many assistants to restrain patients during what were undoubtedly very painful procedures.

Surgical treatment for appendicitis began in earnest during the 1880s. Although doctors struggled to decide who should undergo the knife – some patients would recover on their own without surgery – surgical technique and anesthesia had improved outcomes to such an extent that surgery would rapidly became the gold standard approach. By the end of the 20th century, laparoscopic surgery replaced open surgery in most cases, and laparoscopic appendectomy is now considered one of the safest, lowest-complication surgical procedures performed today.

Notable People who Survived Appendicitis or ruptured Appendix:

  1. 10 Celebrities That Have Had Appendicitis. By R Mappendix, 12 May 2015
  2. Ranker - Celebrities Who Had Their Appendix Removed (21 listed)

Resources & Additional reading:
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