Patients with perforated appendicitis can develop diffuse peritonitis in severe cases if no surgery is performed. The abdominal cavity is more seriously infected after appendicitis perforation, and infective shock can easily occur. If treatment is not performed in a timely manner, patients can die due to infective shock. It is recommended to actively perform surgical treatment to remove and flush the abdominal abscess caused by perforated appendix, and to strengthen anti-infective treatment after surgery. Perforated appendicitis without surgery can form a periappendiceal abscess and cause peripheral intestinal wrapping adhesions, resulting in adhesive bowel obstruction. Therefore, timely surgery is needed in cases of perforation to avoid delaying treatment. If there is no surgery within three days and perforation forms a periappendiceal abscess, it is not even possible to operate again and requires conservative anti-infective symptomatic treatment for three months followed by second-stage surgery.