An ultrasound image of the distended appendix shouldn't be neglected and no conservative management. This 22 years boy had pain in the abdomen and vomiting, Right iliac fossa tanderness, and the rebound was positive. Appendictomy was done.

The appendix is constricted near the base. If postopned, it may burst due to pressure on the end artery causing ischemia of tip of appendix. Appendicitis is otherwise a clinical diagnosis but imaging adds to information.