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Fig. 2. —18-year-old girl with distal appendicitis (false-negative). CT scan obtained with colonic contrast material and 5-mm collimation through lower abdomen and pelvis shows tubular structure that was identified as likely appendix in right lower quadrant. Proximal portion was noted to fill with contrast material (arrow). Findings were initially interpreted as negative for appendicitis. However, at surgery patient was found to have acute distal appendicitis (inflammation of distal portion, or tip, with normal proximal appendix).