Description, Causes and Risk Factors:
Appendicolith is a calcified concretion in the appendix visible on an abdominal radiograph; considered diagnostic of appendicitis in the acute abdomen.
Appendicolith is a conglomeration of firm feces with some mineral deposits. It is usually found accidentally in abdominal computed tomography (CT) without any signs of appendicitis. Appendicolith may obstruct the appendix lumen, causing appendicitis and is found in approximately 10% of patients with appendix inflammation. Appendicitis which is caused by appendicolith is more commonly associated with perforation and abscess formation.
Appendicoliths are seen in about 10% of patients with acute appendicitis. They are more frequently associated with appendix perforation and abscess formation. The appendicolith obstructs the appendix lumen. It also destroys the mucosa with it's local mass effect. Gangrene in the appendix is inevitable. It is important to point out that patients with appendicolithiasis are at increased risk of appendix perforation and abscess formation.
Appendicolith may cause intermittent abdominal pain. It may mimic stone disease of the Genitourinary tract. Sometimes it can be difficult to differentiate acute appendicitis from appendicolith. Both of these pathologies may cause leukocytosis and hematuria. Abdominal findings such as right lower quadrant pain and rebound tenderness can be detected in appendicitis and urolithiasis.
Appendicolith may also cause appendicitis with serious complications including perforation and intra-abdominal abscess formation.
Intermittent abdominal pain.
- Nausea and vomiting.
- Pain migration
Most of the patients with appendicoliths are asymptomatic. However, appendicoliths may also cause serious appendicular inflammation and peritonitis.
Appendicoliths can be detected in abdominal x-ray when they are sufficiently calcified. USG (ultrasonography) and CT may also help in the diagnosis of an appendicolith. The definitive diagnosis of appendicolithiasis could be done with abdominal CT.
Laparoscopy is becoming the preferred approach for various abdominal surgeries. Since the development of laparoscopic ultrasonography (LUS) probes that can be inserted through laparoscopic ports, LUS has been introduced to compensate for this limitation in various laparoscopic abdominal surgeries. Although the laparoscopic removal of appendicoliths is recommended in patients with retained appendicoliths after appendectomy for minimally invasive treatment, localization of the spilled appendicolith may be also an obstacle to surgeons using a laparoscopic approach.
NOTE: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition.
DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.
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