K35.32
Acute appendicitis with perforation, localized peritonitis, and gangrene, without abscess
Clinical Classification Guidelines
Inclusion Terms
- (Acute) appendicitis with perforation NOS
- Perforated appendix NOS
- Ruptured appendix (with localized peritonitis) NOS
Medical Intelligence & Overview
ICD-10 code K35.32 refers to a severe form of appendicitis characterized by perforation, localized peritonitis, and gangrene, without the presence of an abscess. This condition indicates a rupture of the appendix that has led to infection spreading within the localized area of the abdomen. Recognizing the symptoms and understanding the nature of this condition is crucial for timely medical intervention.
Causes & Symptoms
Clinical Causes: Obstruction of the appendiceal lumen due to fecaliths, lymphoid hyperplasia, or foreign bodies Infections that cause inflammation leading to tissue necrosis Delayed diagnosis or treatment of mild appendicitis, allowing progression to perforation Impaired immune response, which may increase susceptibility to infection and perforation
Key Symptoms: Sudden, severe pain around the lower right abdomen Rebound tenderness when pressure is released from the affected area Nausea and vomiting Loss of appetite Fever and chills Abdominal distension or swelling Symptoms may worsen rapidly if perforation occurs, leading to signs of peritonitis
Diagnostic & Treatment
Diagnosis Path: Physical exam revealing tenderness, guarding, and rebound pain in the lower right abdomen Blood tests indicating elevated white blood cell count, suggesting infection Imaging studies such as ultrasound or computed tomography (CT) scan to visualize the inflamed and perforated appendix, assess the presence of gangrene, and evaluate the extent of localized peritonitis Urinalysis to rule out other causes of abdominal pain
Treatment Protocols: Emergency surgery (appendectomy) to remove the perforated appendix and prevent further spread of infection Antibiotic therapy before and after surgery to control infection and prevent complications Supportive care such as IV fluids and pain management Monitoring for any signs of complications, such as widespread peritonitis or sepsis
Clinical Advice & FAQs
Billing Guidance
Is K35.32 a billable ICD-10 code?
Yes, K35.32 is a specific, billable code that can be used to indicate a diagnosis for reimbursement purposes.
Documentation
How do I report K35.32?
Clinical documentation must specify the nature of Acute appendicitis with perforation, localized peritonitis, and gangrene, without abscess and any associated comorbidities for accurate reporting.
Cite this Clinical Reference