Presentation
Lower abdominal pain, fever and loss of appetite for two days' duration.
Patient Data
Right iliac fossa region evaluation with linear ultrasound transducer revealed dilated, non-compressible, non-peristaltic, blind-ended tubular structure measuring about 16 mm at its maximum AP diameter, surrounded by a thin rim of free fluid and echogenic (inflamed) mesenteric fat with few reactive adjacent lymph nodes, containing an echogenic structure measuring 13.9 mm in diameter and casting an acoustic shadow with positive tenderness on probing at the time of the scan.
Case Discussion
This appearance is in keeping with an inflamed appendix containing an appendicolith.
Inflammation of the appendix is called "appendicitis" and mostly affects children and young adults. The etiology of appendicitis is such that when the lumen of the appendix becomes obstructed, luminal stasis occurs leading to an increase in the intraluminal pressure, inflammation, and possibly perforation and abscess formation. A known culprit in the luminal obstruction of an appendix is the appendicolith 1.
Appendicoliths (also called appendiceal lithiasis / appendiceal coprolith / appendicolithiasis / appendiceal fecalith) are calcified masses found within the lumen of the appendix 2. They have been conjectured to be formed by the layering and entrapment of accumulated fecal particulates and the aggregation of organic mineral salts collected in the appendix lumen which solidifies and calcifies over time 3.
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