An appendicolith is a calcified deposit within the appendix. They are present in a large number of children with acute appendicitis and may be an incidental finding on an abdominal radiograph or CT. Incidence may be increased among patients with a retrocaecal appendix. Overall they are seen in 10% of patients, with 90% subsequently going on to develop appendicitis 3.
Although the cause of appendicolith formation is uncertain, some case reports have mentioned an ingested foreign body or a dislodged gallstone eroding through the gallbladder as possible etiologies.
If identified on ultrasound, an appendicolith will appear cast an acoustic shadow. On abdominal radiograph or CT, a high attenuation stone may be seen in the right iliac fossa. CT is more sensitive than plain film. Up to 25% show laminated calcification.
- 1. Lowe LH, Penney MW, Scheker LE et-al. Appendicolith revealed on CT in children with suspected appendicitis: how specific is it in the diagnosis of appendicitis? AJR Am J Roentgenol. 2000;175 (4): 981-4. AJR Am J Roentgenol (full text) - Pubmed citation
- 2. Aljefri A, Al-Nakshabandi N. The stranded stone: Relationship between acute appendicitis and appendicolith. Saudi J Gastroenterol 2009;15:258-60
- 3. Butler P, Mitchell A, Healy JC. Applied Radiological Anatomy. Cambridge University Press. (2012) ISBN:0521766664. Read it at Google Books - Find it at Amazon
The appendix can be affected by numerous inflammatory, infectious and neoplastic conditions:
- appendiceal mucocoele
neoplasms of the appendix
- appendiceal epithelial neoplasms
- appendiceal neuroendocrine tumours
- appendiceal lymphoma