Most chronic appendicitis comes from recurrent episodes of acute appendicitis, while a few are chronic from the beginning. Most of them have a history of previous acute attacks, or they may have less severe and atypical symptoms. There is often right lower abdominal pain, or in some patients, only vague pain or discomfort, and acute attacks can be triggered by strenuous activity or improper diet. The main sign is a limited pressure pain in the appendix, which is often present and fixed in position. Appendiceal streaks may be seen in some patients. Barium enema angiography may reveal an unfilled or incomplete appendix. The key to chronic appendicitis is to exclude intestinal diseases such as intestinal tumors. Sometimes this can be combined with CT to clarify the diagnosis. A definitive diagnosis of chronic appendicitis requires surgical appendectomy and pathological examination for confirmation.