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Fig. 1. 9-year-old girl with acute appendicitis (true-positive). CT scan obtained with colonic contrast material and 5-mm collimation through lower abdomen and pelvis shows markedly enlarged, nonfilling appendix (between straight arrows). Note appendicolith (curved arrow). Fat-stranding is diffuse. Note also arrowhead sign of thickened cecal wall pointing to appendiceal orifice. All findings are consistent with appendicitis. At surgery, patient was found to have acute appendicitis.