A 47-year-old woman, with no past history of interest, consulted for persistent pain in the right iliac fossa following an oesophagogastroduodenal study with barium a year earlier due to symptoms of gastro-oesophageal reflux. Laboratory tests were strictly normal. A colonoscopy was performed up to the terminal ileum, with normal mucosa and calibre; an abdominal X-ray and ultrasound nine months after the barium study showed the presence of barium inside the appendix, with no evidence of acute appendicitis. Due to the persistence of the symptoms, an exploratory laparoscopy was performed where the only finding was an appendix of normal size and slightly congested on its surface, for which appendectomy was performed. The patient evolved satisfactorily with disappearance of the symptoms. Pathological examination revealed a 6 cm long appendix with a congested surface and hyperdense material inside (barium). Microscopy showed lymphoid hyperplasia of the submucosa with fibrosis of the mucosa and submucosa, all compatible with chronic fibrous appendicitis.

