A 10-year-old child with suspected appendicitis came to the emergency surgical department of the Children's Clinical Hospital, sent for an ultrasound scan just in case because clinically and laboratory regarded as a false positive.
On ultrasound, almost the entire right lower quadrant of the abdomen is occupied by an infiltrate (10x5 cm): in the center there is a vermiform appendix up to 1 cm in diameter, around a encysted fluid with septa (abscess), surrounded by a hyperechoic omentum with anechoic streaks (omentitis, local peritonitis), with increased blood flow at CFM.