This An 11-year-old male was admitted to the hospital with a complaint of 8 hours of severe pain in the right lower quadrant of the abdomen accompanied by nausea, vomiting, and diarrhea. Additional features on On admission included a his temperature of was 101° F and he had a leukocytosis of 21,200 cells/mm³ cmm with a shift to the left. An exploratory laparotomy revealed an inflamed appendix, retrocecal in location, which was adherent to the wall of the colon.  The serosal surface of the appendix was covered with friable granular material. The lumen was dilated and contained a purulent exudate as well as a fecalith. The wall measured up to 0.4 cm in thickness.