ruptured appendix and peritonitis

suzanne4, RN · Jan 20, 2004

He will rpobably be in the hospital for at least two weeks. Remember what you learned in your anatomy class, the appendix is part of the GI tract, therefore intestine. One flora of the intestine is E.Coli which is normal there but can cause great problems if it gets into the abdomen from a perforation. He will need some heavy duty antibiotics for awhile. Also,how long does the doctor think that it was perforated for? What this child ill for a week or two before going to the doctor? Unfortunately, it happens alot at that age as they are usually quite shy and don't want to talk to their mother or father about that. As far as specifics outcomes, there are none to give the parents, just know that he is getting the proper treatment.

sbic56, BSN, RN · Jan 20, 2004

My apppendix ruptured with subsequent peritonitis when I was 10. I was in the hospital for 2 weeks and "lost" about 3-4 days. I was in ICU and nearly died I'm told, but obviously did OK with lots of IV antibiotics. That was 37 years ago, so I am betting this little guy will be alright, but I know what he is going through!

PJMommy · Jan 20, 2004

My hubby's appendix perf'd about 3 years ago. He was in the hospital for a total of two weeks and on home health with PICC line antibiotics for a month. He was 29 y/o at the time, great health...a former college athlete. We figure he was perforated about 1-2 days before receiving help (although we SOUGHT help prior to that...but that's another story). Kids are pretty resilient... I would note however that I was the patient's-wife-from-hell until they called in an infectious disease specialist on my hubby. Glad I was demanding -- as that doc changed some meds around, etc. - and that's when my husband turned the corner and started improving.

Okay...side story about the "bad" nurse (this is part of the reason I became a nurse - I figured I could do better than this):

Hubby was being discharged (yes, discharged) two-days post-appy (and he had ruptured...surgeon said appendix was gangrenous). Hubby kept telling nurse he was not feeling well and didn't think he should go home. Nurse's therapeutic response? "Insurance won't pay for it if you stay here." I wondered why he has no script for home antibiotics and nurse's response: "If the doctor didn't write the order, I can't give you any." Duh! Perhaps you could call him? Husband was re-admitted three days later with two softball-sized abcesses in his abdomen, requiring major surgery and another 12 days in the hospital.

Furball · Jan 20, 2004

I had peritonitis back in 1972....horribly ill...but made it home. There were a couple of days where everything was touch and go.

It's very serious but the odds are your nephew will make it. Good luck!

colleen10 · Jan 20, 2004

My husband had appendicitis and an appendix that ruptured when he was 20 years old. That was about 10 years ago.

I believe he had to stay in the hospital a week and a half. He has an extremely large incision compared to what one would have with an unproblematic appendectomy. When he left the hospital they only closed the incision about 2/3 of the way and didn't completely close it for about 2 weeks once he was d/c.

Poor guy, they told him he was supposed to clean around the incisional area including the open portion but no one told him how. He spent 2 weeks liberally pouring Hydrogen Peroxide onto and into the site. It wasn't until he went for a post op. examination that the doc. looked at the incision and asked why the area was so tender and red that they realized what he ahd been doing.

On the plus side, he didn't have any complications after it was removed although he still says the incisional area is tender if he were to really bump it or get hit in that area.

K O'Malley · Jan 20, 2004

Good grief, PJMommy! I would say there was negligence on the part of the doctor and the nurse, the doctor for discharging too soon and not prescribing antibiotics and the nurse for not getting on the phone to the doctor. I had a ruptured appy in 2000 and it was their policy to keep you in the hospital for 3-4 days or longer if the WBC was still up. Did they do a WBC on your hubby prior to discharge? I was sent home on antibiotics and your hubby should have been too.

barefootlady, ADN, RN · Jan 20, 2004

Happened to me. Appendix ruptured at work, did not think it was appendix, thought it was food poisoning, went home and did not return to ER for 3 days. BIG INFECTION. Was rushed to OR, surgeon was an older fellow who used over 10,000cc of gent flush to wash abdominal cavity out. Inserted NG and was put in private room and daughter took care of me. Most importantly, daughter made me do c,t,db every hour to start. Hurt but helped,

She did my leg lifts and ankle rotations for 1st day, then I did them. Was in hospital 1 week. Dr stated that daughter was key to early discharge. Did "old fashioned" nursing and that helped me.

PJMommy · Jan 20, 2004

Originally posted by K O'Malley
Good grief, PJMommy! I would say there was negligence on the part of the doctor and the nurse, the doctor for discharging too soon and not prescribing antibiotics and the nurse for not getting on the phone to the doctor. I had a ruptured appy in 2000 and it was their policy to keep you in the hospital for 3-4 days or longer if the WBC was still up. Did they do a WBC on your hubby prior to discharge? I was sent home on antibiotics and your hubby should have been too.

Yeah, I always thought this was really negligent. I didn't even tell you the part about my hubby seeing a doc the first night he was sick. That guy told him he had gastroenteritis and gave him Darvocet (what??!!!). I have the CBC from that night: WBC 14K and bands at 13% (can you say "left shift"?). Of course, I wasn't a nurse back then so didn't know phooey in order to put in my two cents worth.

But yes, to answer your question -- they did a CBC on him prior to d/c from the hospital. He was still febrile at 102F and WBC and bands were both still elevated. They pretty much just yanked the Zoysn, pulled the IV, and said "go home".

Unfortunately, attorneys are looking for the family who had someone die from negligence....or someone who had the wrong arm amputated. We talked to three attorneys -- all we wanted were medical bills paid and some compensation for lost work time -- but it just wasn't "big enough" for any of them. However, the whole chaotic mess had a *huge* impact on my switching careers and going into nursing. :)

PJ

4everpeace · Jan 20, 2004

Hi.

Same thing happened to my son 2 1/2 years ago when he was 12. Appendix ruptured. Prior to this, he had abdominal pain for about 2 days. Took him to Doc and they did an x-ray and blood tests. Told us it was gas. Recommended anti-gas medicine. Brought him home and he progressively got worse. I called Doc again and said he was not getting any better. She recommended a rectal suppository. (I read after-the-fact that you NEVER give a rectal suppository if appendicitis is suspected as this will cause the appendix to rupture)

Gave him the suppos, and an hour later he was SO SICK! Vomiting, high fever......(I suspect it had ruptured at this point.)

Took him to ER. Fever was 104.4 degrees.

Had appendectomy. Was at hospital 4 days on IV antibiotics and went home with low-grade temp and oral antibiotics.

8 days later, was SICK all over again. Took him back to DR. He immediately had CT scan and was diagnosed with an abdominal abcess. Was readmitted with high fever and put on IV antibiotics. Got progressively worse over the course of 24 hours. My sister is a registered nurse and she recommended that I get a second opinion. FINALLY, called in a second opinion. (Original surgeon was going to leave him on IV antibiotics "over the weekend" to see how he did) In the meantime, he is being placed on cooling blankets and nothing would bring down his high fever)

Second opinion Doc came in and evaluated him and recommended that drains be put in his abdomen to drain infection a.s.a.p. Put drains in the next day. Was placed on double pediatric dose of morphine (with which he hallucinated while on it.) and in severe pain. BUT, fever did immediately go down and also was put back on IV antibiotics. Second opinion Doc said that fecal material was found in the peritoneom and that is what caused the infection, (abcess). The first surgeon was Pis...ed that we called in another Doctor. Had very poor bedside manner and also conveniently left "fecal material" information out of his report. Hmmmmm................

He spent an additional 15 days there and was sent home on oral antibiotics for which he took for 6 weeks!

Was a nightmarish experience, but I am grateful to report that he is now 14 and doing very well!

My advice to your friend is to be bold and ASK QUESTIONS! Talk to people who are in the medical field. Check the internet for information. Be proactive! Get copies of his medical records, if you need them. Don't let fear get in the way. Remember, this is this child's LIFE!

Best wishes to this child for a speedy recovery.

hmccartn · Jan 21, 2004

Thanks for the information everyone!

Jackiegrand · Aug 8, 2010

My son in law has just 3 days ago undergone a ruptured appendix with the fecal matter and pus and the blood work not good. He is experiencing fluid in his lungs so they took him off IV for a bit and got him up to walk around as his tummy is extended. They say day 5 and 7 are days to pass by and look forward to improvement, else then worry. What happens after this is 5 and 7 look bad??? Any answers I could give my daughter?