Acute gangrenous perforated appendicitis is a more serious type of appendicitis, which is mainly caused by gangrene of the appendix leading to necrosis and perforation, which is caused by interruption of blood flow to the appendix due to various reasons. Once perforated, appendicitis can cause acute peritonitis, which in severe cases can lead to diffuse peritonitis with high fever and shock. During examination, patients with acute gangrenous perforated appendicitis are often found to have high fever, platysmal abdomen, pressure pain and rebound pain in the abdomen, and the pain is very severe, often resulting in shock. The main treatment is early surgery, and after surgery, the inflammation can be cured with proper diet and antibiotics.