This is a rare case of a dropped appendicolith.  After discussion with the surgical team, due the position of the appendicolith percutaneous drainage by interventional radiology was not felt to be the appropriate first-line treatment and the patient went to theater for an open laparotomy and wash out.  The appendicolith was removed and the patient made a complete recovery and was discharged 7 days later on oral antibiotics.

Dropped appendicoliths are a rare finding with less than 30 cases reported within the past 40 years ¹. The most common sites are the paracaecal region and Morrison's pouch ¹. All modern (since 2004) reported cases have been following a laparoscopic technique. The limited available literature provides case report evidence to support a trial of image-guided intervention prior to open surgery ¹.