Can a burst appendix be treated without surgery?

No, the rupture will leak fecal matter and bacteria of various kinds into the peritoneal cavity. Antibiotics, because they travel through the bloodstream, won't take care of the whole problem. A surgeon will need to go in and wash out the cavity as well as take out the problematic appendix. However, in some cases - if the appendix has been ruptured for a while - for days or weeks- it may be too inflamed and there may be a large pus pocket, or abscess. In these cases, the pus can be removed with a tube called a drain and the patient is given a course of antibiotics. Once the inflammation has calmed down, many doctors recommend having the appendix removed 6 to 12 weeks later so that appendicitis will not recur. Other doctors say the chances of a second case of appendicitis is low (<20% chance it could happen again..) and that it does not need to be removed. If a later surgery is recommended, surgeons can remove it using laparoscopic approach with tiny incisions.