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Case Reports
. 2021 Jan 29;2021(1):rjaa543.
doi: 10.1093/jscr/rjaa543. eCollection 2021 Jan.

Re-assessing the role of the fecalith in acute appendicitis in adults: case report, case series and literature review

Nguyen Tran  1 , Valerie-Sue Emuakhagbon  2 , Bradford T Baker  3 , Sergio Huerta  1
Affiliations
Case Reports

Re-assessing the role of the fecalith in acute appendicitis in adults: case report, case series and literature review

Nguyen Tran et al. J Surg Case Rep. .

Abstract

Appendicitis in adults is thought to occur because of luminal obstruction from a fecalith. We present a unique case of a patient who had her entire appendiceal lumen occupied by a fecalith (5.0 cm long) but had no appendicitis. We reviewed the records of 257 veterans who underwent surgical intervention at our institution for the management of acute appendicitis. Fecaliths occurred in 15.6% of patients. At laparotomy, 20.6% had a perforated appendix; pathology showed fecaliths in 20.8% of specimens. A review of the literature inclusive of 25 series showed fecaliths in 33.3% of patients with a normal appendix, 23.5% of patients with acute appendicitis and 24.9% with perforated appendicitis. These data show that appendicitis is not a common cause of fecalith obstruction in adults.

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Figures

Figure 1
Figure 1
CT of the abdomen and pelvis. Serial images (A–D) from cephalad to caudal show a large fecalith (arrows).
Figure 2
Figure 2
Appendiceal specimen received by pathology (A). There is a 5.0 × 0.8-cm tan/dark green fecalith filled within the lumen of the appendix (B).
See this image and copyright information in PMC

References

    1. Cameron JL, Cameron AM Current Surgial Therapy. 10th edn. Philadelphia: Mosby, 2011:219.
    1. Fitz RH Perforating inflammation of the vermiform appendix. Am J Med Sci 1886;92:321–46.
    1. Arnbjornsson E, Bengmark S. Obstruction of the appendix lumen in relation to pathogenesis of acute appendicitis. Acta Chir Scand 1983;149:789–91. - PubMed
    1. Singh JP, Mariadason JG. Role of the faecolith in modern-day appendicitis. Ann R Coll Surg Engl 2013;95:48–51. - PMC - PubMed
    1. Khan MS, Chaudhry MBH, Shahzad N, Tariq M, Memon WA, Alvi AR. Risk of appendicitis in patients with incidentally discovered appendicoliths. J Surg Res 2018;221:84–87. - PubMed

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