Which of the following is a classic sign of chronic appendicitis?

Chronic appendicitis is characterized by intermittent symptoms rather than constant. Patients typically experience episodes of right lower quadrant pain that come and go, which may lead to a delay in diagnosis. During the asymptomatic periods, individuals may feel well, but as the condition flares up, they can experience pain that is usually localized to the right lower quadrant. This intermittent pain can vary in intensity and may be accompanied by mild digestive disturbances, but it is certainly not as acute and constant as seen in acute appendicitis.

In contrast to this, constant right lower quadrant pain often indicates acute appendicitis, while severe nausea and vomiting, along with fever and chills, are more common signs of an acute inflammatory process, suggestive of a more severe or acute appendiceal issue rather than a chronic one. Thus, intermittent right lower quadrant pain stands out as the classic presentation of chronic appendicitis.