Extraluminal appendicolith: an indication for interval appendectomy with intraoperative localization and removal of that potential cause of intra-abdominal abscess

Journal of Laparoendoscopic & Advanced Surgical Techniques. Part a
Rafael ItahRon Greenberg

Abstract

Appendicoliths are formed by calcium salts and fecal debris layered and lodged within the appendix. They are detected on unenhanced X-rays in <10% of patients with appendicitis. When an appendicolith is found extraluminally, it is pathognomonic for perforation of the appendix. Moreover, retained appendicoliths are likely to be infected and to be the source of a postoperative intraperitoneal abscess, whereupon the only definitive treatment is surgical excision. In this paper, we describe an asymptomatic patient with evidence of an extraluminal appendicolith on computed tomography following successful conservative treatment for a periappendicular abscess. She underwent a laparoscopic interval appendectomy that included the removal of an extraluminal appendicolith and was released home on the following day. We advocate this approach in order to prevent the possible formation of an intra-abdominal abscess caused by an infected nidus.

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Citations

Jul 22, 2009·AJR. American Journal of Roentgenology·Young S SongPeter M Nardi
Oct 2, 2009·Saudi Journal of Gastroenterology : Official Journal of the Saudi Gastroenterology Association·Ahmad Aljefri, Nizar Al-Nakshabandi
Feb 19, 2016·Journal of Clinical Ultrasound : JCU·Jovan LovrenskiIvan Varga
Aug 21, 2009·The Journal of Surgical Research·Joannele Z LugoI Michael Leitman
Sep 21, 2011·Annals of the Royal College of Surgeons of England·S SarkarA A Egun

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