The appendix is a tube-like structure that is connected to the cecum. The cecum is a structure located at the junction of the small and large intestines. Some experts think that the appendix is a vestigial organ, which means that it is an organ that has lost most of its original function due to evolution. The human appendix length ranges from 5 to 35 cm. With a diameter of 6 mm, anything more than 6 mm would be considered inflamed and thickened. In most cases, the appendix is located at the lower-right quadrant of the abdomen with the base 2 cm beneath the ileocecal valve. On the surface, its position corresponds to McBurney’s point.
Appendicitis occurs when there is inflammation of the appendix caused by a blockage in the hollow portion of the appendix. Some causes of blockage include calcified stones from feces, inflamed lymphoid tissue, tumors, and parasites. When blockage occurs, there is increased pressure in the appendix, resulting in decreased blood flow and increased bacterial growth. While the diagnosis of appendicitis is largely based on the individual’s signs and symptoms, other tests such as medical imaging and laboratory tests can also be helpful. Appendicitis is one of the commonest causes of severe abdominal pain that has a rapid onset. In 2015, there were an estimated 11.6 million cases of appendicitis, which led to about 50,000 deaths.
The approximate interval between the start of symptoms until rupture of the appendix ranges from 36 to 72 hours. The severity of rupture varies depending on the size. Some may have a small spillage into the abdominal cavity while others may have a big rupture where there is pus and stool in the abdomen. When rupture occurs, the bacteria enters the abdominal cavity and causes inflammation in the intraabdominal cavity, known as peritonitis. Treatment includes the removal of the ruptured appendix via surgery. The abdominal cavity will need to be cleaned to minimize bacteria. Antibiotics will be administered to ensure that the infection has resolved. Pain can be managed using prescription pain medicine.
Symptom #1: Abdominal Pain
When there is a ruptured appendix, there can be severe abdominal pain that is exacerbated by movement such as sneezing and coughing. While appendicitis is mainly felt in the lower-right quadrant, a ruptured appendicitis would involve the entire abdomen. Other associated symptoms would be rigidity of the abdomen along with abdominal guarding (tensing of the abdominal muscles).
There can also be abdominal tenderness where pain is elicited by pressing on the abdomen. A ruptured appendix is considered a medical emergency and immediate medical attention is necessary.