Appendicular perforation is a severe complication of untreated or delayed acute appendicitis, where the inflamed appendix bursts, creating a hole that releases pus and intestinal contents into the abdominal cavity. This causes peritonitis (abdominal infection) and can lead to sepsis, requiring emergency surgical treatment.
At Dr. K.K. Verma’s center in Jabalpur, we specialize in the rapid diagnosis, surgical management, and critical care of patients suffering from appendicular perforation using advanced laparoscopic and open surgery techniques.
An appendicular perforation usually occurs when acute appendicitis is left untreated for more than 24–48 hours. The pressure inside the appendix increases until it ruptures, spilling infected material into the abdominal cavity.
Delayed diagnosis or treatment of appendicitis
Immunosuppression or diabetes
Elderly patients with vague symptoms
Children or pregnant women (where symptoms may be atypical)
Sudden, severe abdominal pain
Pain that begins in the upper abdomen and spreads throughout
Rigid or board-like abdomen on touch
Nausea or vomiting
Fever and chills
Rapid heartbeat, low blood pressure
Inability to pass gas or stool
Signs of shock in severe cases
⚠️ This is a life-threatening emergency — immediate medical attention is essential.
Timely and accurate diagnosis is essential to prevent widespread infection and complications.
Intense lower abdominal tenderness (especially right lower quadrant) Rebound tenderness or guarding Symptoms of generalized peritonitis
Elevated white blood cell (WBC) count Raised CRP and markers of inflammation Electrolyte imbalance
May show a ruptured or inflamed appendix with surrounding pus or abscess
Gold standard for diagnosing perforated appendix Identifies abscesses, pus collections, and inflammation spread
The treatment goal is to control infection, remove the ruptured appendix, and clean the abdominal cavity.
Preferred in stable patients with localized infection Involves 2–3 small incisions to remove the appendix and clean the infected area
Required in unstable or severely infected cases Larger incision to allow thorough cleaning and drain placement
Irrigation of abdominal cavity to remove pus, infection, and prevent sepsis
A surgical drain may be inserted to allow continuous removal of infected fluids
After surgery, patients are shifted to ICU or monitored closely.
Patients may need 5–10 days in the hospital depending on the infection’s severity and recovery.
Continued for several days post-surgery to eliminate residual infection
Oral intake is resumed once bowel movements return, starting with liquids and soft food
Monitoring of surgical wounds Removal of drains (if placed) Long-term infection prevention and recovery guidance
In perforation, the appendix has burst, causing widespread infection. It is more dangerous and requires urgent treatment.
Yes, in stable patients. But if the infection is widespread or the patient is critical, open surgery is preferred.
The infection spreads throughout the abdomen (peritonitis), leading to sepsis, multi-organ failure, or death.
Most patients recover in 1–2 weeks with proper care. ICU care may be needed in severe cases.
Laparoscopic surgery leaves small scars; open surgery may leave a longer incision mark.
Dr. K.K. Verma is a renowned laparoscopic surgeon known for his precision and patient-centric care. With years of experience and advanced surgical skills, he specializes in minimally invasive procedures that ensure quicker recovery. His dedication to excellence has earned him the trust of countless patients.
shop no 29, 30, stadium ROAD, opposite Satya Ashoka Hotel, Wright Town, Jabalpur, Madhya Pradesh 482002
drkrishan.kant@gmail.com
+91-7835924276
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