Medical Questions > Conditions and Diseases > Appendix and Appendicitis Forum

Ruptured appendix - leaving the appendix in

After 6 weeks of having an abdominal mass in my lower right quadrant which gradually became larger I went to A and E. After tests they found a large abscess formed around my appendix with the cause likely being a ruptured appendix. Through a surgically implanted drain (which is still in me) and many antibiotics the abscess looks to be almost all cleared up. I return to clinic on the 12 th when they decide if the tube can come out. My doctor said to me that in cases like mine, 9 times out of 10 removal of the appendix is not needed as the appendix is likely to be "disintigrated". So my questions are:

Has anyone heard of leaving an appendix left in (or whats left of it) after rupture? Is it possible for it rupture again?

I noticed a mass in my lower right abdomin a month before I went to hospital. Is it possible that I was living with a ruptured appendix for a month? (the mass was smaller at this point compared to when I actually went to hospital)

For the past 2 and a half years I have struggled with stomach cramps and rumbling particularly after eating which I put down to ibs. Since I first noticed the mass these symptoms have greatly decreased in severity and frequency, could they be related? (chronic appendicitis??)

When return to clinic on the 12th I will hopefully have the drain removed, but thats all they plan to do. I will then go for a CT scan, but not for another 3 months. How can they be sure the abscess has fully drained/everything is ok and feel confident to leave it for 3 months to find out?

Sorry for all the questions I am just a little concerned and I thank anyone who took the time to read this
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replied May 18th, 2013
I have a similar story. Several months ago while on vacation, I was diagnosed with ruptured appendix and a "walled off abscess." The rupture had occurred at least a week before, drs thought, and I didn't feel that sick. Initially the surgeon said that I may not need surgery if the abscess goes down with antibiotics and/or draining...although he said this is a brand new way of handling some cases of ruptured appendix. So I was admitted to a small hospital in upstate NY and treatment began. However, my white blood cell count kept increasing...even after four days of IV antibiotics. And it was not possible for doctors to insert a drain b/c of the location of the abscess. Surgery would have been very dangerous at that point. I live in Manhattan, so thankfully I was smart enough to transfer to a major hospital there. I got the right antibiotics and abscess diminished. However, my drs agreed that a laparoscopic appendectomy should be performed within a few months because the abscess can recur, and there are dangers. I had the surgery 5/13. The surgeon found (and removed) pieces of my ruptured appendix that had attached to some of my organs. This had not been detected on ct scans. The bottom line is: I think you need a second opinion. And if you can, go to a top doc at a major hospital.
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replied May 18th, 2013
Thanks for the reply.

The abscess I had was 10x9x10 cm and the doctor said it was the biggest appendiceal abscess he had seen. He mentioned that because of this I still have a lot of inflammation in the area the abscess covered and everything is 'stuck'. He said for that reason surgery wouldn't be a run of the mill appendectomy and that there are risks. He has told me that is my decision whether or not to have surgery and I'm really not sure what I should do.

At this point in time I am leaning towards not having surgery due to the risk factor but it is a difficult decision.

Is there anyone else on here who has had a ruptured appendix in the past without removal? What has your experience been?

As ever thanks for the replies
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replied May 26th, 2013
My colon was inflamed a lot, too, and pieces of appendix stuck to organs. Surgeon waited 6 -8 wks til the abscess diminished and inflammation lessened...so that there was minor surgical risk. The surgery took two and a half hours compared to the normal half hour. But the surgeon is experienced in this area, and came highly recommended, so I had great confidence. Everything went well and I am recovering nicely, feel great and do not have to worry about abcess recurring and relateed problems. Did you try to get a second opinion about the risks of NOT operating? How old are you and what country do you live in?
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replied May 27th, 2013
I am 21 and I live in England. I will be going for a colonoscopy soon which will hopefully give us a better idea of the state of my appendix and whether or not an interval appendectomy is the right thing to do.

I have a question regarding the draining process: My tube was removed about a month ago now but it continues to drain fluid daily. The doc said that where the tube lay in me would have created a track that will take time to heal. It smells as though some fecal matter is coming out which the doc said was a possibility as the rupturing of my appendix could have created a pin sized hole in my colon where the appendix is (or was). How long did it take for you to stop draining after the tube was removed?
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replied June 2nd, 2013
Hi, Dejabu: How are you doing now? Did you have the colonoscopy? I hope your doctor was able to give you clearer answers and a successful treatment plan. I surely hope the drain issue is better...It seems unreasonable that you should have to deal with foul-smelling fluid coming out. I do think you should try find a doctor who is very experienced in dealing with ruptured appendix and related problems. Wishing you the best!
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replied June 22nd, 2013
Here's an update on my situation. I had the colonoscopy which found scarring in the cecum likely caused by the ruptured appendix. They took a biopsy of the area and I am still waiting for the results.

I had a check up with the team that have been working on me yesterday and they were surprised to see that I was still draining fluid at this stage and I now have to go for a test to see if it is a fistula that is making my colon 'communicate' with the skin and causing the discharge. If it is, my doctor told me that I may have to have a section of my colon removed which is very worrying.

Don't really know what to think at this point in time, just want it all to be over...
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replied July 16th, 2013
Hi, Dejabu: How are you? I hope things are going well and you are on the mend. Please let me know. Btw, did you hear that Elton John has ruptured appendix and abcess, too? At least we are in good company. Best, Appchat
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replied June 23rd, 2013
Thanks for the update. You are going through a lot. But try not to worry...it sounds to me like everything is fixable and ultimately not serious. Colonoscopy is routine for appendix problems. Scarring in cecum and resultant colon resection surgery due to ruptured appendix should not cause any lasting problems. Colon resection surgery is fairly common, btw. I had a section of my colon removed during appendectomy last month for same reasons as you. My husband also had a colon resection at a young age (due to a more serious problem)and he is fine. Your drain/fistula issue will turn out ok, too. Best wishes and please keep me posted!
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