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Ruptured Appendix

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"Nurse, it's an appendix!"
Dr. Cohn, Madeline

When writers want to add a little drama but don't want to spend a lot of time building up symptoms and later dealing with recovery, they'll dust off this old chestnut: The Burst Appendix.

What makes appendicitis great for writers is that it can affect an otherwise completely healthy character with little or no advance warning (in sharp contrast to real life appendicitis, for reasons explained below), a sort of Sickness Ex Machina if you will, and instantly creates a sense of ticking-time-bomb tension as the character must get the appendix removed before it explodes! The situation also takes delightfully little time to fix: rush your character through some emergency surgery, spend a few seconds admiring the cool, new scar, and that's it; roll credits.

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You can expect fictional portrayals of appendicitis to ignore all of the other symptoms associated with it in favor of the intense, stabbing and often completely debilitating pain that appears in your abdomen. While this is a major symptom, as well as typically being the biggest red flag that something is very, very wrong with your body, it is not the only symptom—others include mild fever, forms of irritable bowel syndrome, nausea/vomiting, loss of appetite, among other unpleasant things. In fact, many of these symptoms (especially the fever and nausea) often come before the intense abdominal pain arrives.

As a fairly common and thus well-known condition, appendicitis/ruptured appendix also falls under Small Reference Pools. Tonsillitis, and occasionally gall stones, can get similar treatment. Gall stones also add some drama in that they are less dangerous but have extremely similar symptoms to the appendicitis, thus adding suspense due to the need to distinguish them.

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(If you have severe stomach pain in the lower right side or that started there and spreadnote , go to an emergency room. DO NOT take an enema or laxative or otherwise try to force a bowel movement – the pressure/stimulation of bowel contractions can cause the appendix to rupture. Also, have the surgery, because while it may give you a scar (which will be quite small if they use an laparoscope) and may result in some occasional bowel issues later in life due to the appendix hosting beneficial bacteria, both of those can be easily dealt with – and the surgery is the only absolute cure that ensures the condition won't worsen and kill you, or return if cured via antibiotics or other nonsurgical treatment.

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Subtrope of Sick Episode.

Has nothing to do with the extra parts of books.

No Real Life examples, please, unless they're extremely interesting.note 


Examples

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    Anime and Manga 

    Fan Works 
  • In the Kim Possible fanfic Alone, Together, Kim and Shego are stuck in an otherwise unpopulated alternate universe long enough to become friends (and eventually more). When Kim develops appendicitis, Shego has to remove it, guided only by a frantic review of medical texts from the hospital.
  • John Gage's appendix ruptures before Roy and the ambulance can get him to Rampart in the Emergency! fic "A Big Deal''
    • A few other writers have done this as well, the medical nature of the show makes it an attractive storyline.
  • Ghostbusters (1984):
    • In I Have Your Back, Peter Venkman gets appendicitis but initially mistakes it for stomach flu and tries to work through it.
    • In Love Sick, Egon gets a cramp that he thinks is a pulled muscle, but then it turns out to be appendicitis, while Janine worries that it's food poisoning because she'd cooked him some spaghetti and meatballs.
  • The Inside Out fanfic Emotion Sickness focuses on how Riley's emotions deal with the situation when she gets appendicitis.
  • In Kill la Kill AU, we have this with Satsuki in comic 35 and this marks her as an ill girl, as stress had done a number on her health to that degree. She turns out okay.
  • In Crystal Rose of Pollux's "Lone Star and Union Jack" collection of Monkees vignettes, a teenaged Davy contracts appendicitis.
  • In Chapter 26 of the Lucky Star fanfic Lucky Star: After Story, Yutaka ends up developing appendicitis during her and Minami's senior year in college. After her appendix is removed, her overall health ends up improving greatly.
  • In My Brave Pony: Starfleet Magic, this is why Fluttershy has a Sick Episode and is nearly killed by a changeling in the hospital, even though ponies don't have appendixes.
  • The climax of No Guts, No Glory, a fanfic for The Powerpuff Girls (1998), has Buttercup rushed to the hospital for an appendectomy in the middle of a monster fight.
  • In the Nichijou fanfic, Not a Normal Day, Hakase gets appendicitis and has to be rushed to the hospital. Luckily, she comes out of it just fine.
  • Punch-Out!! fanfic:
    • One chapter of Hold Me has Narcis Prince land in the hospital to get his appendix out after he wakes up at four A.M crying and won't calm down.
    • The Grand Finale of Ma Fille puts Joe down for an appendectomy after his ninety-ninth loss.
    • Ma Fille's Sequel Series Shining and Sweet has the chapter "Gut Punch", wherein Aran Ryan follows Joe's path of collapsing after a match and needing to be taken to the hospital for an appecdectomy.
  • Rugrats:
  • The Phineas and Ferb fanfic Sick Streak.

    Literature 
  • The mother has appendicitis in Sydney Taylor's All of a Kind Family Uptown and recovers.
  • Happens in Epic: Eric gets appendicitis and has to drop out of the competition to move up to the next grade level.
  • There was a Baby-Sitters Club special that was kicked off by Kristy being stuck in the hospital with appendicitis. She receives a chain letter from a friend while recovering, and starts to send it to the rest of the club, who are all off on summer vacation.
  • In Roald Dahl's autobiography Boy, Dahl recalls being so homesick during his first term at boarding school that he tried Playing Sick by faking appendicitis, just to be able to go home for a few days. The examining doctor wasn't fooled (the lack of physical symptoms, despite the boy's Large Ham performance in screaming with pain, was a dead giveaway), but agreed to keep Dahl's secret.
    Roald Dahl: You might think it silly that a nine-year-old could imagine that he would get away with a trick like that, but I had sound reasons for trying it on. My ancient half-sister had actually had appendicitis, so I was able to observe her behaviour at close quarters.
  • Lu Clarke has one in Cherry Ames: Mountaineer Nurse by Julie Tatham. Since she's in a remote valley, she barely makes it to the hospital in time.
  • In George R. Stewart's 1949 novel Earth Abides Isherwood Williams, who has survived a global plague and is one of the few survivors on Earth, makes a list of positive things that may indicate his survival. One of them is the fact that he has already had his appendix out, so he doesn't have to worry about this.
  • Doc Leroy, one of the characters in J.T. Edson's Floating Outfit series of western novels, once saved the life of a cowhand with a burst appendix by operating on him with a Bowie knife.
  • Freckle Juice: Discussed when Andrew drinks the eponymous drink (a mixture of grape juice, wine vinegar, mustard, mayonnaise, lemon juice, pepper, salt, ketchup, brine, and onion), he feels very nauseated. When he tells his mother he has a sore tummy, she thinks he must have appendicitis, until she sees the dishes he left in the kitchen and concludes he got sick from something he made.
  • The Garden of Sinners has an excellent example: The main villain of the third novel, Fujino Asagami, has a severe case of appendicitis, which leads her to believe she'd been stabbed. (It's complicated.) By the end of the episode, her condition has worsened to a point where even immediate attention is pointless; she's vomiting blood and barely able to crawl. And that's before we mention the killer chasing her, or the repeated rapes she endured previously. It ends comparably well for her, when Ryougi Shiki (who can literally kill anything) kills the appendicitis inside Fujino with her powers and saves her life.
  • In Ray Bradbury's The Halloween Tree, the boys who accompany Moundshroud on a Time Travel tour of Halloween's history are offered the chance to give up a year of their own lives to save their friend Pipkin from this trope.
  • In Jonny D Boggs' "Hard way out of Hell" Cole Younger's brother Dick dies of appendicitis. Cole is quite shocked.
  • House of the Scorpion: In El Patron's backstory, one of his siblings died from this, since his family couldn't afford a doctor.
  • In one of John Bellairs's Lewis Barnavelt novels, while Mrs. Zimmerman and Rose Rita are driving home, Mrs. Zimmerman is overcome with a crippling pain in her stomach. She believes it's her appendix, which leads to Rose Rita remembering how a classmate of hers died after mistaking appendicitis for a bad stomachache and didn't seek treatment until it was too late. When Mrs. Zimmerman gets to the hospital, it's revealed that the pain was too high to have been her appendix. Mrs. Zimmerman tells Rose Rita that she suspects it was actually the effects of a dark magic curse someone used on her.
  • The Hunt for Red October: Due to drunkenness while on duty, a surgeon botched removing an inflamed appendix from the wife of Marko Ramius, the organ bursting because the doctor took too long to try to sober up by breathing pure oxygen.note 
  • In one of the Jonathan Cap books by Francois Rivier, the local Plucky Girl Juliette nearly develops this and she's sent to a luxurious private clinic for treatment. It almost happens for real when she, Jonathan, Alex and Nico are investigating the clinic at her request; she tries to help out Jonathan when he's forcibly given sleeping drugs, but she near collapses in pain. Thankfully her appendix remains in one piece and she recovers.
  • Lethal White: Cormoran's nephew Jack's appendix actually does rupture, and it nearly kills him. His parents were away on vacation, and Cormoran, whose POV passages often emphasize how he doesn't really like children, ends up being the one going to the hospital. Even Cormoran is surprised by how upset he is.
  • Madeline had appendicitis in her first book, and the scene was also included in the movie adaptation, the '50s animated adaptation, and the first animated special. Some of her dolls even include the scar from the surgery.
  • Robert Merle's novel Malevil has a similar situation. The few survivors of a nuclear holocaust lose the protagonist when he eventually dies of appendicitis.
  • In Stephen King's The Stand, after the superflu wipes out most of humanity, one of the survivors dies of appendicitis, because there are no doctors left around. Stu tries to remove it, only to have the patient die partway through the operation. Then the guy's wife commits suicide afterward.
  • Teenage Worrier's Worry Files has Letty's brother being rushed to hospital with appendicitis for the drama factor.

    Live-Action TV 
  • In the final season of All in the Family, 10-year-old Stephanie comes down with appendicitis on her birthday.
  • On Barney Miller, Nick Yemana developed appendicitis in the aptly named episode "Appendicitis."
  • In The Big Valley, Audra contracted appendicitis in the episode "Last Train to the Fair."
  • Birds of a Feather: In "Love On The Run", Darryl (who's in prison) has appendicitis and has to be rushed to the Royal Infirmary, which sets up the plot of him wanting to escape so that he can have a night out with Tracey. Additionally, Tracey lies about Garth having appendicitis so that she can get away without telling Tracey.
  • CSI had a variation of this, the serial killer Dr. Jekyll, who implanted a guy with a diseased appendix. Naturally, it killed the guy later.
  • In the Taiwanese Series Devil Beside You, Ahmon goes onstage after the lead guitarist goes down with appendicitis. He then gets to guitar suggestively in front of his love interest.
  • A Diff'rent Strokes episode had Arnold develop appendicitis and is too scared to the doctor until he meets a girl who is having a similar operation (her tonsils) and would be sharing a room together in the hospital. But when the girl's father decides against it after finding out Arnold is black, Arnold and the girl run away and the families have to search for them before Arnold's appendix bursts.
  • Doogie Howser, M.D.: 16-year-old Doogie rushes his appendicitis-stricken girlfriend, Wanda to the ER straight from their Drive-In Theater date. He proceeds to diagnose her (via pelvic exam!) and assist in the operation himself. Trouble ensues because he didn't have time to properly ask for the required authorization from her parents (Wanda is 16 and a minor as well), and they're not happy. (Wanda herself is mostly embarrassed that Doogie saw her naked, and she gets better).
  • ER did an episode where Dr. Benton had to have his appendix removed, and Carter (much to his delight) was assigned to operate on him.
  • Bright Abbot has this happen in the first season of Everwood, but it's not sudden and immediate; he's shown having stomach pains at the beginning of the episode but goes to his grandmother's birthday party anyway. Andy and Harold realize the appendix is inflamed and it only bursts when Bright tries to get up. Andy ends up removing it himself in his office, and Bright recovers.
  • Also occurred in Family Matters, in the episode "Number One With a Bullet" where Steve Urkel collapses in the middle of the Winslows' floor from this.
  • F Troop: Happens to Chief Wild Eagle in "Miss Parmenter"; the men of F-Troop must operate on him, with Captain Parmenter's sister serving as an assistant.
  • This occurred in an episode of Full House with Uncle Jesse, coincidentally while he was in the hospital while his twins were being born.
  • April quickly develops appendicitis after an embarrassing argument with Luke in Gilmore Girls. Luke has to call Lorelai, who's recently married Chris, for advice when April is clutching her side. Lorelai comes to the hospital afterward, and it's what makes Luke realize exactly how much he screwed up by driving her away.
  • On Gomer Pyle, U.S.M.C., Sergeant Carter wound up needing to have his appendix removed in "Gomer Tends a Sick Cat."
  • On I Dream of Jeannie, Jeannie blinks Tony into a doctor just as Roger gets wheeled into the hospital for an appendectomy.
  • In The Kids Are Alright Timmy faints after complaining that his stomach hurts. When Mike and Peggy take him to the hospital, they find out he has appendicitis, and has to get his appendix removed.
  • In the Land of the Giants episode "The Creed," Barry gets appendicitis. This forces his fellow castaways to enlist the help of a giant doctor.
  • Happened on an episode of Laverne & Shirley; Shirley gets appendicitis while in costume rehearsing for their "Alice in Wonderland" play.
  • In the Sweet 16 episode of Life with Derek, Casey comes down with appendicitis. On her sixteenth birthday.
  • On Lost, Jack, the survivors' team doctor, had to have his appendix removed while on the island.
  • In the second season of Malcolm in the Middle, Malcolm goes to hospital with what's assumed to be appendicitis. Ultimately turned on its' head as the diagnosis proves to be wrong.
  • M*A*S*H:
    • In "White Gold," Hawkeye and Trapper conduct unnecessary appendix surgery on Colonel Flagg, who wants to make off with the camp's penicillin inventory.
      • Several seasons later, Hawkeye drugs a dangerous colonel and makes him think he has acute appendicitis. In a deliberate case of series-wide Character Development, this it's not treated comically, and BJ Hunnicutt refused to go along with it.
        B.J.: It's mutilation!...If you do this you'll hate yourself!
        Hawkeye: I already hate myself! I hate me, I hate you, and I hate this whole life here! But if I can keep that maniac off the line with a simple appendectomy, at least I'll hate myself with a clear conscience.
    • In "The Long John Flap", Col. Blake is wearing the titular long underwear, and Hawkeye and Trapper threaten him, when suddenly Blake reacts as though punched. Turns out it's his appendix rupturing, and they have to operate immediately. The entire camp is mildly happy to hear that Blake's appendix was successfully and safely removed... but overjoyed at hearing that they didn't have to cut him out of the long underwear to do so, and so the long underwear was intact.
    • Major Houlihan is mentioned in one episode to have chronic appendix flare-ups, and that she'll be fine and doesn't need surgery as long as she takes a brief break from performing surgeries until it calms down. She intends to eventually get it removed in the city, but just in case, she requests that Hawkeye be the one to operate if necessary despite Frank Burns usually being the surgeon to perform minor operationsnote . Of course, it becomes necessary to remove the appendix, and while she can't get to Tokyo or even Seoul, Hawkeye removes the appendix with little problem beyond Burns attempting to horn in on the operation.
    • A later episode has Hawkeye performing an appendectomy on a singer with a USO troupe. He spends the rest of the two-episode story dissuading the obvious crush she develops on him, thinking a sweet young woman like her deserves a more honorable man in her life than Hawkeye.
  • In an episode of The Nanny, Maxwell contracts appendicitis and is taken to the hospital where Fran has disguised herself as a candy striper.
  • On Night Court during the story arc where Dan, an Army Reservist, gets activated and sent to Alaska. A local Eskimo woman has to have her appendix removed and since he accidentally caused the local doctor to injure both of his hands, Dan must perform the procedure, with the doctor talking him through it.
  • The Punky Brewster episode "Ouch" has Punky suffering from appendicitis. The thought of being operated on frightens her to tears, and she hides out in a hospital closet. Betty (Cherie's grandmother) finds her and persuades her to have the operation done.
  • In the Quantum Leap episode "Ghost Ship", Sam leaps into a pilot who must safely guide a plane out of the Bermuda Triangle and save one of the passengers from dying of appendicitis. Unusually for this trope, her appendix actually bursts, but Sam is able to use his medical knowledge to provide supportive care until they reach a hospital.
  • In Road to Avonlea, as everyone tries to throw a birthday party for Hetty King, she falls ill and has to have her appendix removed, with the doctor warning that it could burst at any minute.
  • In Australian children's TV adaptation of The Saddle Club, Lisa (one of the three central characters) is alone on horseback when she's overcome by the pain of Appendicitis and collapses on the trail.
  • In the episode of Scrubs entitled "My Day Off" J.D. develops appendicitis and has to experience the hospital from a patient's point of view.
  • Daniel has very little to do in the Stargate SG-1 episode "Nemesis", as he's recovering from an emergency appendectomy. This was because Michael Shanks was recovering from an appendectomy himself.
  • Colton Cumbie was removed from Survivor One World with symptoms that mirrored appendicitis. (To which Kat asked where it was) However, during his appearance on Blood vs. Water, Probst reveals that Colton might not have actually had it, and even accused Colton of faking it!
  • In Series 2 of Warehouse 13, the Team Medic (in the persona of the original Bionic Woman) answers Artie's call for a second appendectomy — he claims that being around all the artifacts made it grow back. Turns out he was using P.T. Barnum's spinning-top, which can "grow" multiple arms, legs, etc., to regrow it: he had taken a shine to the woman. She has to make a call somewhere else, and doesn't get around to removing it. When it gets bad, Artie has to go to the town vet.

    Newspaper Comics 
  • In Retail Cooper suffers one of these. It nearly burst because Cooper refused to see a doctor because he doesn't have health insurance, and the $20,000 bill he receives after the surgery nearly sends him into bankruptcy until he wins a big prize in a fast food joint contest.

    Theater 

    Video Games 
  • Mega Man Battle Network: In the second game, the player can come across a sick passenger in an airport complaining about his stomach. Later in the game, you can run into him, and he'll mention that he had appendicitis.
  • Trauma Center: New Blood has the player character racing against time to remove an infected appendix before it bursts. Afterwards, they immediately operate on another patient whose appendix had just burst.
  • One sub-story in Yakuza, Kiryu gives food to a boy who's waiting for his mother, but the boy falls ill. The only doctor available is currently operating on an African man named Ali, who is immediately abandoned for the boy, resulting in a Mistaken for Racist moment and obligatory battle against Ali's brothers. Turns out that while the boy was suffering from appendicitis, which is extremely dangerous, Ali just had a kidney stone, which is extremely painful but ultimately harmless, so the doctor was fully justified in abandoning the foreigners in favor of fellow Japanese.

    Web Original 

    Western Animation 
  • Near the end of the final season of As Told by Ginger, shortly after her breakup with Darren, Ginger is left feeling as if her "insides exploded". It's discovered that the pain she's been experiencing isn't solely because of the breakup, but is in fact due to acute Appendicitis. She's rushed to the hospital for an emergency Appendectomy.
  • In the Back at the Barnyard episode "Cowdyshack", Otis accidentally ruptures his friend Crazy Louie's appendix and seeks to replace it with a new one that's the prize for winning a golf tournament. They win the prize, only for Crazy Louie to discover that the appendix is a completely useless organ, so he sells it for money to get extra thumbs, which horrifies the gang.
  • In The Fairly OddParents episode "The Five Days of F.L.A.R.G.", Mark claims that if he's unable to celebrate the Yugopotamian holiday of Flarg, his appendix (which he pronounces as "app-in-dix") will burst. Unfortunately, his appendix is a nuclear device that's powerful enough to destroy Earth.
  • An episode of Garfield and Friends, called "Galactic Gamesman Garfield", had Jon suffer from appendicitis, though Garfield's obsession with a video game didn't help him at all... but between the antics of Odie and the noise from Garfield playing the video game, they managed to alert the paramedics in time.
  • Happens to Hector on one Ozzy & Drix episode. Here the appendix is depicted as a roadside motel with swelling attributed to an unscrupulous manager trying to get it filled to the brim.
  • Happened on Rocko's Modern Life in the episode "Tickled Pinky". Before the procedure, Rocko has a dream in which his appendix is a little kid whom he consoles with a trip to the fair (and other, increasingly silly last requests) before he's taken out.
  • On The Simpsons:
    • In "Boy-Scoutz 'n the Hood", Dr. Hibbert performed an emergency appendectomy on the street, then threw the appendix away as if it were a live grenade. It even exploded like a grenade.
    • Another when Bart gets a stomach ache after accidentally eating a jagged metal toy from the Krusty cereal. He's sent to the hospital with what turns out to be appendicitis. Which can't be caused by eating metal, by the way.
  • In the Unikitty! episode "Kaiju Kitty", Richard's position on the Shining Mecha Kitty Turbo V robot is the appendix, which according to Dr. Fox, "just sits there and occasionally explodes", much to Richard's annoyance. It ends up turning out to be housing the self-destruct mechanism for the mech, saving them during permanent lockdown.
  • In an episode of The Wild Thornberrys that takes place in Australia, poor Eliza has the misfortune of not only developing Appendicitis on Valentine's Day, but also that the commvee and mini-comm are immobile. It's a possible life or death situation as Nigel overcomes various obstacles to get her to a hospital.

    Real Life 
  • This trope is Truth in Television – and it's actually quite common that almost everyone has at least heard of appendicitis or an appendix injury.
    • It's also surprisingly common for assumed appendicitis cases to turn out to be false alarms...and sometimes, they don't realize this until after the offending organ is removed!
    • It's common for childhood appendicitis to be mistaken for stomach flu—even by the doctors. This can result in the child not getting their appendix removed until after it has ruptured. Worse still, it may end with the poor kid dying as a result of peritonitis, with the parents Outliving One's Offspring.
  • Harry Houdini died of a ruptured appendix, which may or may not have been exacerbated by someone punching him in the stomach a few days earlier—one theory is that he may have attributed the early symptoms of appendicitis to pain from the blow, and did not seek help as soon as he would have otherwise.
  • Leonid Rogozov, a Russian doctor, got appendicitis. While on an expedition in Antarctica. Where he was the only doctor. So he operated on himself.
    • This led to a policy of preemptively removing the appendix of critical staff members (with their consent) before any trip to the base.
  • Similar to the Rogozov example above, some jobs and/or activities that involve traveling to remote areas where evacuation is difficult or impossible will also require or at least suggest preemptively removing the appendix. Astronauts are the most well-known example, but others, such as hikers planning to solo-hike remote areas, will also sometimes have this done.
  • James Roday Rodriguez from Psych, was hospitalized with appendicitis and had to have it removed just prior to his scheduled appearance on WWE Raw. He recovered and was even able to make a literal phoned in appearance during the episode, albeit highly medicated and somewhat loopy.
  • BUCK-TICK vocalist Atsushi Sakurai developed abdominal peritonitis from a Ruptured Appendix while in Nepal in late 1996, and was diagnosed as potentially terminal. He demanded to be sent home to Japan to die, and somehow, against all odds, recovered once he was back in Japan, becoming one of the very, very few people to survive a ruptured appendix and subsequent peritonitis.
  • Masaki Koh, a gay adult video star, developed appendicitis but refused surgery for several reasons (including appearance and that his condition was so advanced that the surgery itself could have ruptured the appendix) and instead chose nonsurgical treatment with antibiotics and the like. Unfortunately, his appendix ruptured, and he would later die from abdominal peritonitis.
  • Ringo Starr, drummer of the The Beatles, nearly died at age six from peritonitis; he missed a year of school while recovering and remained sickly for most of his childhood as a result. It was his constant illnesses and inability to catch up academically that played a big role in him turning to music.

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