Thanks for writing in HCM.
The CT findings point towards a chronic infection. Thickening of the ileum
associated with abdominal pain
is usually due to chronic infections such as TB or Crohn's disease.However in India TB is more common. If the appendix
is not seen on Ct it would be futile to remove the appendix. A good trial of conservative treatment accomapanied by a proper reassesment will help rule out appendictis.
I hope this answers your querry.