The reasons why acute appendicitis is prone to necrosis and perforation are as follows: 1. Appendicitis attacks are usually caused by fecal stone impaction, which after impaction will affect the discharge of secretions from the appendiceal cavity, thus leading to swelling of the appendix. After the appendix is swollen, it will affect the blood flow and blood transport; 2. The appendix wall is very thin, which can easily cause perforation. After swelling, fluid and pus will accumulate in the appendiceal cavity. As bacteria multiply and the tension becomes high, it will break through the appendix wall, leading to appendiceal necrosis and perforation; 3. The appendix has only a single blood vessel supply, which can easily cause ischemia. Ischemia will lead to appendiceal wall breakage, necrosis and perforation.