It used to be that almost everyone had their appendix removed at some point during their childhood. Now, the surgery isn’t as common, and many adults still have their appendix.
What is appendicitis though? It is the inflammation of the appendix, a small organ attached to the large intestine. Doctors thought that the appendix didn’t have any function in the past, but now they aren’t sure. Since we can live without our appendix, it is often removed by a surgery called an appendectomy if it becomes infected. The first known case of a successful appendectomy was in the 1700s.
Your appendix can become inflamed for several reasons. It can be blocked by mucus, stool (bowel movement), or lymphatic tissue. This is part of the lymphatic system that helps fight infection. The normally harmless bacteria in the appendix then attack the appendix walls, resulting in inflammation and infection. Bacteria, viruses, and parasites from your digestive tract can also cause an infection. If left untreated, the appendix wall can burst, causing the infection to spread in the abdomen, possibly resulting in sepsis or septic shock.
Sepsis, which was often called blood poisoning, is the body’s life-threatening response to infection. Like strokes or heart attacks, sepsis is a medical emergency that requires rapid diagnosis and treatment. Worldwide, one-third of people who develop sepsis die. Many who survive are left with life-changing effects, such as post-traumatic stress disorder (PTSD), chronic pain and fatigue, organ dysfunction (don’t work properly), and/or amputations.
Sepsis may also occur as a complication of the surgery in general.
Common Appendicitis Symptoms
There are three stages of appendicitis:
- Normal appendix
- Uncomplicated acute appendicitis (still intact)
- Complicated appendicitis
There are no specific appendicitis tests, but your doctor may ask for imaging tests like an x-ray or a CT scan to rule out any other issues that may cause your symptoms.
Appendicitis warning signs, including appendicitis pain, are not always obvious at first. Inflammation can develop for up to 48 hours before anyone notices the symptoms. Because of this, it is essential to seek medical help when the symptoms do appear. The usual signs and symptoms of appendicitis include:
- Constipation, diarrhea, or gas
- Dull, achy pain beginning around the belly button (navel), turning to sharp pain in the lower right abdominal pain
- Loss of appetite
- Low fever
- Nausea and vomiting
- Rebound tenderness: tenderness when pressure applied to the lower right abdomen is released
More advanced symptoms
- Abdomen swelling and rigidity (hard)
- Pain on the right side of the abdomen when pressed on the left side
Some doctors have started treating simple appendicitis with antibiotics before going ahead with appendicitis surgery. According to an article from the University of Washington Medical School:
“In the first three months after taking antibiotics for the condition, nearly 7 in 10 patients in the antibiotic group avoided an appendectomy. By four years, just under 50% had the surgery,” said Dr. David Flum, co-principal investigator and professor and associate chair of surgery at the University of Washington (UW) School of Medicine. “Other outcomes favored either antibiotics or surgery. Putting it all together, antibiotics look to be the right treatment for many, but probably not all, patients with appendicitis.”
However, many people with appendicitis still have an appendectomy. The type of appendectomy depends on whether the appendix has burst or is still intact.
An appendectomy for an intact appendix is usually done laparoscopically. This is a minimally invasive appendix surgery. There are no large scars. Instead, the surgeon makes some tiny incisions and inserts special equipment with a camera. The surgeon watches through the screen as they move the tools to detach and remove the appendix. Healing is usually much faster with this type of surgery.
If there are complications or the appendix has burst, the surgeon will likely have to do open abdominal surgery. The surgeon must make a larger incision to see inside the abdomen. After removing the appendix, the surgeon cleans out the abdominal cavity to reduce the risk of infection, which could lead to sepsis. Surgery may not always be necessary though. Sometimes an abscess blocks off the infected area, keeping the infection contained. If this happens, the doctor may offer antibiotics first to see if that will get rid of the infection.
People who had a burst appendix often must stay in the hospital, usually with IV antibiotics, for three to five days to ensure the infection is treated properly.
If you suspect sepsis, call 9-1-1 or go to a hospital and tell your medical professional, “I AM CONCERNED ABOUT SEPSIS.”
The information here is also available as a Sepsis Information Guide, a downloadable format for easier printing.
Would you like to share your story about sepsis or read about others who have had sepsis? Please visit Faces of Sepsis, where you will find hundreds of stories from survivors and tributes to those who died from sepsis.
Updated December 8, 2022.