A Clinical Study on Appendicular Perforation and its Management

Introduction: Appendicular perforation (AP) is a severe complication of acute appendicitis, associated with significant morbidity and mortality. This study aims to evaluate the clinical profile, intraoperative findings, and postoperative complications in patients with appendicular perforation. Aim and Objective: To analyse the prevalence, clinical presentation, surgical outcomes, and complications of appendicular perforation compared to nonperforated appendicitis. Materials & Methods: A prospective study was conducted over one year, including 90 patients diagnosed and surgically managed for acute appendicitis and its complications. Data on demographic details, clinical features, intraoperative findings, and postoperative outcomes were collected and analysed statistically. Results: Out of 90 patients, 25 (27.8%) had appendicular perforation, with a male predominance (76%, p=0.04). Appendicular perforation was most prevalent in children aged 0–10 years (46.15%) and adults 50 years (40%). Late presentation (≥72 hours) was observed in 88% of perforation cases (p=0.02). Fever was significantly more common in perforation cases (72%) than nonperforated appendicitis (41.5%, p=0.0096). The distal third of the appendix was the most common perforation site (56%). Postoperative complications, including surgical site infection (28%, p=0.01) and prolonged ileus (16%, p=0.027), were higher in perforation cases, with a median hospital stays of six days. Conclusion: Appendicular perforation predominantly affects males, extremes of age, and those with delayed presentations. It is associated with higher rates of fever, distal appendix perforation, and postoperative complications, including infections and ileus. Prompt diagnosis and management are crucial to reducing morbidity.