Pelvic inflammatory disease caused by appendicitis requires surgical treatment in clinical practice. Appendicitis causes pelvic inflammatory disease because the appendix becomes septic, causing pus to flow into the pelvis through the paracolic sulcus; the appendix becomes gangrenous and perforated, causing pus to enter the pelvis through the paracolic sulcus. The symptoms are rarely high fever, but mainly rectal irritation caused by pelvic fluid accumulation, manifested as abdominal pain, abdominal distension, urgency, and rectal finger examination can feel the fullness and pressure pain of the anterior rectal wall. For pelvic inflammatory disease caused by appendicitis, surgery is the preferred treatment when rectal irritation occurs.