Appendicolith

Case contributed by Dr Roberto Rafael Ovalle

Presentation

Diffuse abdominal pain and leucocytosis

Patient Data

Age: 35 years old
Gender: Male
X-ray

Abdominal AP X-ray demonstrate the presence of five appendicolith projecting over the right iliac crest. Ultrasonography was inconclusive because the appendix was difficult to evaluate due to the presence of abundant intestinal gas.

Annotated image

Annotated image shows the presence of five appendicoliths.

The patient underwent open surgery after X-ray findings and acute appendicitis was found.

Case Discussion

The appendicolith, also known as “fecolith” or “corpolith”, represents calcified deposits in the appendix, and contributes to the pathogenesis of acute appendicitis. It is defined as an area of high attenuation measuring ≤ 1 cm that is located in the pericecal areas, or in cases of perforation in the Morrison's (Douglas) pouch.

The finding of an appendicolith may be sufficient evidence to perform a prophylactic appendectomy in asymptomatic patients, given the higher rate of perforation at the time of acute appendicitis.

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Case information

rID: 45003
Case created: 11th May 2016
Last edited: 11th May 2016
Inclusion in quiz mode: Excluded

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