It can be.
The appendix is found in the right lower abdomen; some people have the tip of the appendix very close to the right ovary.
Therefore, in the era prior to ct scans and ultrasounds, it was very difficult to differentiate diseases of the tubes and ovary (ruptured cyst, pelvic inflammatory disease
) from appendicitis
. Even now, these tests are not perfect, sometimes requiring exploratory surgery.