Management of acute perforated appendicitis in adults

* Perforated appendicitis, also referred to as complicated appendicitis, is characterized by a palpable mass in the right lower quadrant on physical examination or by a phlegmon (inflammatory mass) or abscess on imaging studies. Refer to the separate UpToDate algorithm for the management of nonperforated appendicitis in adults.

¶ Immediate appendectomy, as opposed to interval appendectomy, should be performed within 12 hours of the decision to operate, except in the case of an unstable/septic patient or the presence of free perforation or generalized perforation, where surgery should be performed as soon as possible.