Don’t need answer fast, but back in pre-medical times before surgery I’m assuming a lot of appendixes burst. What is the mortality rate for a burst appendix? What about with antibiotics but no surgery (lets assume it happens on a submarine or Antarctica and they have antibiotics but no surgeon)?
My appendix ruptured back in 1973, and I came DAMN close to not making it. The surgery was botched* and I got severe peritonitis. The incision didn’t entire close for two years. I imagine in previous years, this sort of thing happened more frequently. i don’t think antibiotics without surgery would help much with that kind of infection. No surgeon? I would have operated on myself; I couldn’t have done a worse job.
*at Long Island College Hospital, which has since been closed down.
It’s hard to imagine that there are reliable statistics for modern antibiotics but no surgery. Where would the sample come from?
It’s going to be hard to find accurate statistics, partly because acute appendicitis wasn’t recognized as a clinical entity until the late 19th century (by that time, surgery was starting to be a reasonable option). Here’s an article on the history of appendicitis.
I’d think that mortality from acute peritonitis secondary to rupture appendices was pretty high in the days before competent surgery and antibiotics, but a certain percentage of people were fortunate in that the inflammatory/infectious process was localized and they recovered.
This is a crappy answer because my internet access is stone age at the moment.
I half remember a story about a med school intern deciding that she/he was too busy to have her appendicitis treated and decided to treat with antibiotics alone.
Googling this phrase- intern opts to treat appendicitis with antibiotics - gives good answers on treatment with ABX alone on both acute (ruptured) and non-acute.
Here are some Finnish statistics on treating non-acute appendicitis with ABX alone.
Leonid Rogozov was the only Doctor present at the Soviet Antarctic Expedition in 1961. He developed appendicitis and removed his own appendix. The surgery was done using Novocaine, while a meteorologist held a mirror so Rogozov could see his surgical site. Surgery took a few hours, and was a success.
Not a statistic but an anecdote; my friend had her gall bladder removed and about 10 days later began having severe pain. While waiting in the hospital hallway on a gurney, her appendix ruptured. Her doctor assured her that because she was still on antibiotics after the gall bladder surgery, she was at no risk. Apparently he was right as she did just fine – or as fine as one can do after having all these body parts rise up to smite her.
Doctor Rogozoff was just badass. In Soviet Union, Appendix Removes You!
The 1804-1806 Lewis & Clark expedition, the only member to die on the trip was Sgt. Charles Floyd, who wrote in his diary that he had been sick for some time, but recovered. Then he took a turn for the worse. Some doctors suggest his appendix had ruptured providing temporary relief and he died from peritonitis. He wouldn’t have fared any better in civilization. He is buried along the Missouri river near Sioux City, Iowa.
Probably pretty high, it’s difficult to find statistics on something like that, for obvious reasons. One could assume the risks of any part of the bowels being punctured, or ruptured would be the same as a burst appendix. Bacteria flowing, causing peritonitis, inflammation and sepsis. Sepsis on its own is still rather deadly these days. IANAD Though. Just researched a bit in the past because I had my own removed, slight rupture (not the exact word a doctor used but it “popped”) but it happened while I was already en route to surgery.
Would be hard to find accurate statistics. Appendicitis classically presents with pain and vomiting that migrated from the belly button towards the right hip, and lots of sometimes signs and symptoms. It can be easy to miss, I’ve had a couple come back to the ER days later but fortunately both were given good advice on what to look for. In most people, symptoms are very severe after bursting and elderly patients with many comorbities are in trouble despite surgery and antibiotics. Fortunately, many appendicitis patients are younger.
If your appendix burst, you need good antibiotics, pain meds and stat surgery. So you need to be close to a hospital with a surgeon, which most people are.
If I were to ballpark a modern answer to your question, I would guess ruptured appys in all patients have a mortality rate of 5-10%.
I found a few studies from 20+ years ago that said the incidence rate of appendicitis is about 23 per 10,000 people, and usually effects males and people between ages of 10-19 Don’t know if that’s still accurate or would be accurate for people in the 1800’s. But if so, in 1850, there were 23 million people in the US, so about 53,000 of them would contract appendicitis during their lifetime, and most likely not survive.