Antonakopoulos et al1 studied 15 pathological specimens of obstructive appendicopathy identified by H&E staining but failed to report on the clinical data of these patients or merely the indication for appendicectomy. In the absence of scarring and inflammation, they suggested that it is more likely a congenital anomaly characterised by failure of the mucosa to extend to the distal end of the developing appendix, causing distal lumen obliteration and occasionally hypoplasia of this part of the organ. A normal-looking appendix or one with a narrowed distal end is easily identifiable by the experienced surgeon during laparotomy. …