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©2013 UpToDate ® Print Email CT scan equivocal appendicitis The patient is a 56-year-old male who presents with right lower quadrant pain. The CT scan of the lower abdomen in the axial plane (A) and the magnified view of the appendix (B) show a normal sized appendix with surrounding induration (red arrow). The periappendiceal induration raises the possibility of appendicitis. The associated thickening of the posterior peritoneum (orange arrow) suggests an acute process in the right lower quadrant. However, the epicenter of induration (yellow arrow in A and B) in the region of the tip of the liver (L) and ascending colon (C) suggests that the process likely originates in that region. Thus the process around the appendix is secondary and not primary to the appendix.