Appendicitis cannot be seen on plain film. Generally, chest and abdominal fluoroscopy is mostly used as a routine examination. When combined with diffuse peritonitis, standing abdominal plain film should be performed to exclude ulcer perforation and acute strangulated intestinal obstruction. If free gas under the diaphragm is present, appendicitis can be excluded. Acute appendicitis can also sometimes show positive results on abdominal plain films, with one or several stone shadows visible in the right lower abdominal appendix in about 5%-6% of patients. The diagnosis of appendicitis is mainly based on clinical symptoms and cannot be confirmed by radiographs alone.