The classical history in acute appendicitis is that of initial colicky central abdominal pain that moves after 6-12 hours to the right iliac fossa (RIF) where it is constant in nature [1]. This classic history is only present in half of the patients that present to the ED with appendicitis [1].

Other common symptoms include anorexia (which tends to be present in 80% of patients with appendicitis), nausea, vomiting (which starts after the pain) and constipation or diarrhoea [2]. Appendicitis often presents with an atypical history, particularly in the elderly, children and pregnant patients, and can make these very difficult diagnostic groups, where the diagnosis may be made late and the risk of perforation is higher [4].