A precise diagnosis for appendicitis has a high degree of difficulty, due to the resemblance of appendicitis's symptoms to those indicating other inflammations. Thus, a frequent method is to keep under observation the patients with appendicitis suspicion for a temporal interval, to see their evolution. The problem may disappear, or develop to classic appendicitis or other disease.

It is the duty of the surgeon to eliminate the suspicion for any other condition similarly to appendicitis or that has similar symptoms. Such conditions are:

* - Meckel's diverticulitis represents little excrescences of the small intestine which are usually found in the lower right abdomen right next to the appendix. Same as the appendix, the diverticulum can rupture or inflame and it is necessary to take it out by surgical intervention.

* - Pelvic inflammatory disease. Found closely to the appendix, the ovary and the right fallopian tube may be affected by sexually transmitted affections of infectious nature, but in most of the cases medication using antibiotics can successfully replace surgery.

* - Right upper abdomen conditions of inflammatory nature. Diseases like duodenal ulcer, gallbladder disease or affections of the liver may generate fluids drain from upper to lower right abdomen and cause a very similar inflammation to that of the appendix.

* - Right - side diverticulitis. By exception from the common situation of the left sided diverticulitis of the colon, there can also appear on the right side and, when rupturing, have a strong similarity to appendicitis.

* - Affections of the right kidney such as abscess which, due to the close position of the kidney to the appendix may simulate appendicitis.

Because many conditions of the abdomen share the same symptoms, the causes are in more than one case difficult to determine, but the good thing is that only few abdominal affections are so serious to require more than medication at home. So, the nature of pain is more likely to be determined by severity, location or other aspects.