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:

  1. Normal appendix
  2. Uncomplicated acute appendicitis (still intact)
  3. 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:

Early symptoms

  • 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

Treating Appendicitis

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.

Suggested Citation: Sepsis Alliance. Sepsis and Appendicitis. 2022.

Updated December 8, 2022.

Read Personal Stories of Sepsis and Appendicitis

Judith Clark


In 2015 I was on a cruise ship on the Atlantic Ocean when my appendix ruptured. (Sepsis and Appendicitis) After hours of waiting, a Portuguese military helicopter airlifted me to the Ponte Delgada in the Azore Islands. I had a ruptured appendix and sepsis for about 8 hours. It was difficult to know how long I went with a ruptured appendix prior to surgery. After 5 hours of surgery and 2 weeks in the hospital, I returned home to the San Francisco Bay Area. Since then I had 2 surgeries for an incisional hernia and 1 surgery for adhesiolysis. Through ... Read Full Story

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Alyne Vasques da Silva

Survivor, Survivor

I spent a good part of the time looking for help in medical offices followed by several hospitalizations without any probable diagnosis, that’s when dyspnea, severe pain, high fever, edema and confusion started. It was then that I went to the operating room and found that I had a complicated asymptomatic appendicitis, which rendered me several days in a coma struggling in the ICU to cure sepsis, with some more severe complications came mediastinitis, necrosis in a part of the intestine , peritonitis and a stopper in the tracheostomy tube that led to a cardiorespiratory arrest that is difficult to ... Read Full Story

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Autumn-Nicole B.

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I survived mass sepsis after my appendix burst at fifteen. It was not caught in time and destroyed half of my reproductive system. (Sepsis and Appendicitis) I went through months of post sepsis admits. This past year I came down with a sore lymph node under my arm and I literally went to sleep from the pain at the end of April 2022. Finding myself waking up in the I.C.U. with a PICC line an open incision with a vacuum in it from having sepsis with necrotizing fasciitis. After many surgeries and a three week stay in the I.C.U. I ... Read Full Story

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Savon Khiev

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04/26/2022, my husband (38 years old) had acute ruptured appendicitis that led to severe sepsis. (Sepsis and Appendicitis) Luckily, we made it to the hospital in time after he returned back to Houston from Austin. It led to acidosis, collapsed lung, pericardial effusion, and he had a heart attack. He was in the hospital for about a week, but now we are told he may have an abscess because there’s a mass in his right abdomen. He had an exercise stress test and failed it, so he will be doing a nuclear stress test in a few days to see ... Read Full Story

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Barbie Nesser

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Hi my name is Barbie and I am 62 years old. It was June of 2020 when I had my 4th UTI in 6 months. (Sepsis and Urinary Tract Infections) I was prescribed Macrobid on June 10th. By Friday I was experiencing back pain. It was late in the day, but I decided to call my primary doctor. Luckily my doctor called me back. She asked if we could FaceTime. My doctor thought I did not look very well and I also developed a stye in my eye and I never had them before. It was evident that I was ... Read Full Story

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Appendicitis is the inflammation of the appendix, a small organ attached to the large intestine. In the past, doctors thought that the appendix didn’t have any function, but now they aren’t sure. Since we can live without our appendix, if it becomes infected, it is often removed by a surgery called an appendectomy