A Four-Year Hospital Journey for a Lost and Migrating Appendicolith

Abstract

We report a rare case of recurrent abscess formation, including being at a retroperitoneal site, due to a lost and migrating appendicolith. Over a four-year period and following an episode of perforated appendicitis, an otherwise healthy young man underwent two operations for abscess formation with eventual stone removal. Appendicoliths can pose a challenge during the diagnostic and therapeutic journey, and adequate attempts at removal need to be made to prevent avoidable complications. In patients suffering from recurrent flank pain and abscesses after appendectomy, the possibility of a lost or overlooked appendicolith should be considered.

Migrating appendicolith: A retained appendicolith causing recurrent infection and migrating to the skin

“…The retained appendicolith can act as an infected foreign body which cannot be sterilised by antibiotics. 1–3 Because of the presence of other densities of similar size within the abdomen ( e.g., faecoliths, phleboliths), a migrated appendicolith can be difficult to identify on conventional medical imaging. Retained appendicoliths have the potential to migrate throughout the peritoneal cavity, making identification potentially difficult.…”

“…A retained appendicolith is a rare complication that can arise from ruptured appendicitis. 1–5 A retained appendicolith has the potential to migrate within the body and act as a nidus for recurrent infection. 1,2 We present a case of recurrent infection over a 12-month period occurring secondary to a migrating appendicolith.…”