A young man presented with 1 day of diffuse abdominal pain which was now maximal in the right iliac fossa.
There is a blind ended, aperistaltic, non compressible 8mm tubular structure which seems to originate from the caecum. Color Doppler shows hyperaemia. There is a small amount of free fluid seen adjacent to the tip.
This case demonstrated all the features of appendicitis. Note that a gangrenous appendix may be ischaemic and therefore not be hyperaemia and may 'decompress' so that it may not be enlarged. Not visualizing the appendix does not exclude appendicitis.