Perforation from Appendicitis

Delay in seeking medical care appears to be the principal reason for perforations; the appendicitis has just been allowed to progress according to its natural history. Perforation is accompanied by more severe pain and higher fever (average, 38.3 °C) than in appendicitis. It is unusual for the acutely inflamed appendix to perforate within the first 12 hours. The appendicitis has progressed to perforation by the time of appendectomy in about 50% of patients under age 10 or over age 50. Nearly all deaths occur in the latter group.

The acute consequences of perforation vary from generalized peritonitis to formation of a tiny abscess that may not appreciably alter the symptoms and signs of appendicitis. Perforation in young women increases the subsequent risk of tubal infertility about fourfold.