Appendicolith

Appendicolith

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.

Symptoms:

Symptoms include:

Intermittent abdominal pain.

appendicolith
  • Anorexia.
  • Nausea and vomiting.
  • Fever.
  • Pain migration

Most of the patients with appendicoliths are asymptomatic. However, appendicoliths may also cause serious appendicular inflammation and peritonitis.

Diagnosis:

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.

Treatment:

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.

6 Comments

  1. Neeraj N Nair

    Recently I was diagnosed for nephrolithiasis and when underwent CT scan found none but impression was “medially placed appendix was found with noted appendicitis, size appears 7mm.

    Kindly suggest if it is for the panic button to be pressed, what should be done, kindly advice.

    Reply
    • editor-m

      Thank you for your comment. Please, try to find more information about nephrolithiasis here https://www.medigoo.com/articles/nephrolithesis/
      After all, please, contact your doctor for more precise examination and recommendations for treatment.

      Reply
  2. Tina Randolph

    I had a CT of my abdomen and pelvis.I’m reading over some of my medical records I have downloaded. It says,Several small appendicolith,Minimal enlargement of the Appendix at 9mm with periappendiceal edema and fat standing suspicious for acute non complicated appendicitis.goes on to say LARGE amount of fecalmatter in the colon. This test was taken a few months before I went into the ER on a Sunday morning they said I had acute appendicitis as they were taking out 12 hours later My question is how far in advance world they have to do a test to find out I should have my appendix removed. The Dr.that performed the surgery said it took him 3 hours to get out.He was amazed that they didn’t rupture, said it was as big as a baseball. They had to put so much gas in me to open up to get it all, pain after I woke up was worse than childbearing, I did natural with 2 children over 9 LBs.

    Reply
    • editor-m

      Thank you for commenting. Hopefully, it is not so bad everywhere. We wish you to find good spesialists and consult them.

      Reply
  3. Sudhakar

    My wife diagnosed with tiny appendicolith. Please advise me about treatment.is there any option to cure with medicine or only option to undergo laparoscopy surgery.

    Reply
    • maisteri

      Appendicolith is not an indication for surgery, it rather indicates the risk of developing appendicitis in the future and do not require any treatment (and there are any). So the appendectomy is usually not performed unless there are symptoms of appendicitis.

      Reply

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