Chronic appendicitis, unlike acute appendicitis, does not begin with upper abdominal pain followed by pain in the lower right abdomen, which we refer to as migratory lower right abdominal pain; migratory lower right abdominal pain is a characteristic symptom of acute appendicitis. Chronic appendicitis typically presents with chronic recurrent pain, discomfort, dull pain, or bloating in the lower right abdomen. During a physical examination, chronic appendicitis generally manifests as fixed tenderness in the lower right abdomen, with less evident rebound pain. Rebound pain in the lower right abdomen during a physical exam only occurs when chronic appendicitis acutely flares up and signs of peritonitis are present.