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.
On this page:
Pathology
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 aetiologies.
Radiographic features
If identified on ultrasound, an appendicolith will appear to 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.
Treatment and prognosis
During the Covid-19 pandemic, there has been an increase in conservative management of appendicitis, due to the risk of aerosol generation during anaesthesia and laparoscopy 4. However, the presence of an appendicolith in the context of acute appendicitis is associated with failure of conservative management and increase in complications 5.
Unable to process the form. Check for errors and try again.