You've made the correct conclusion. Management of a perforated appendix is vastly different from management of the (much more common) uncomplicated appy. There

You've made the correct conclusion. Management of a perforated appendix is vastly different from management of the (much more common) uncomplicated appy. There isn't much controversy about the management of the perforated appy: it's going to be surgery and antibiotics. Removal at that point isn't in question, because the perforation is due to an increase in intra-appendiceal pressure compressing its vasculature, causing a focal necrosis. The perforation happens when a piece of the appendix dies, and thus loses its integrity. Dead tissue has to go. And of course surgical clean-up of the abdomen must follow, along with a big pile of abx.