A perforated appendix is one of the complications of acute appendicitis

A perforated appendix is one of the complications of acute appendicitis. When appendicitis is left untreated, necrosis (gangrene) of the appendiceal wall can occur and progress to a focal rupture.

Although ultrasound is less accurate than a contrast-enhanced CT, the findings can be appreciated in experienced hands.

Intraoperative or gross pathology examination reveals a full-thickness defect in the appendiceal wall. Histopathology demonstrates neutrophilic infiltration and transmural necrosis with extensive mucosal ulceration (gangrenous acute appendicitis).