DOI: https://doi.org/10.36347/sjmcr.2026.v14i04.060

Pages: 842-843

We report the case of a 14-year-old girl presenting with acute abdominal pain initially suggestive of appendicitis. The clinical picture included central pain migrating to the right iliac fossa, localized tenderness, and elevated inflammatory markers. However, imaging failed to visualise the appendix and instead demonstrated ileal thickening with mesenteric lymphadenopathy. The patient improved spontaneously and was discharged on oral antibiotics with a working diagnosis of ileitis. This case highlights the diagnostic overlap between appendicitis and ileitis in paediatric patients, underscores the limitations of imaging when the appendix is not visualised, and emphasises the importance of careful clinical judgment, close observation, and conservative management to avoid unnecessary surgical intervention.