A prospective study of 60 children with appendicitis suggested a correlation between the length of symptoms prior to perforation and the level of appendiceal obstruction. These observations support the concept that obstruction of the appendiceal lumen near its tip leads to early perforation, while obstruction near the base leads to late perforation.
(JAMA 244:806-807, 1980)
Deck KB, Pettitt BJ, Harrison MR. The Length-Time Correlate in Appendicitis. JAMA. 1980;244(8):806-807. doi:10.1001/jama.1980.03310080040023