Appendiceal fecalith is associated with early perforation in pediatric patients

Alaedeen, Diya; Cook, M. M.; Chwals, Walter J.

doi:10.1016/j.jpedsurg.2007.12.034

Cited by 69 publications

(57 citation statements)

References 20 publications

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“…The appendix was perfor ated in 57% of patients who had a fecalith versus 36% of patients without a fecalith. 8 However, there are differing opinions on the topic, bringing into question the theory of the appendiceal fecalith (for an example, see the study by Maenza and colleagues 9 on "the myth of a fecalith."). A PubMed search reveals a plethora of literature on the topic "appendicitis and fecolith" or "appendicitis and coprolith.…”

Section: Resultsmentioning

confidence: 99%

Association between the appendix and the fecalith in adults

Ramdass¹,

Sing²,

Milne³

et al. 2015

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Background:We sought to determine the association between the presence of a fecalith and acute/nonperforated appendicitis, gangrenous/perforated appendicitis and the healthy appendix. Methods:We retrospectively analyzed appendectomies performed between October 2003 and February 2012. We collected data on age, sex, appendix histology and the presence of a fecalith.Results: During the study period, 1357 appendectomies were performed. Fecaliths were present in 186 patients (13.7%). There were 94 male (50.5%) and 92 female patients, and the mean age was 32 (range of 10-76) years. The fecalith rate was 13%-16% and was nonexistant after age 80 years. The main groups with fecaliths were those with acute/nonperforated appendicitis (n = 121, 65.1%, p = 0.041) and those with a healthy appendix (n = 65, 34.9%, p = 0.003). The presence of fecaliths in the gangrenous/perforated appendicitis group was not significant (n = 19, 10.2%, p = 0.93). There were no fecaliths in patients with serositis, carcinoid or carcinoma. Conclusion:Our data confirm the theory of a statistical association between the presence of a fecalith and acute (nonperforated) appendicitis in adults. There was also a significant association between the healthy appendix and asymptomatic fecaliths. There was no correlation between a gangrenous/perforated appendix and the pres ence of a fecalith. The fecalith is an incidental finding and not always the primary cause of acute (nonperforated) appendictis or gangrenous (perforated) appendicitis. Further research on the topic is recommended.

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Section: Resultsmentioning

confidence: 99%

Association between the appendix and the fecalith in adults

Ramdass¹,

Sing²,

Milne³

et al. 2015

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“…Their finding in a tomography has a 65% sensibility, 86% specificity and a 74% positive predictive value for acute appendicitis diagnosis [21]. That is, if a appendicolith is associated to abdominal pain, an acute appendicitis possibility is almost 90% and the risk of gangrenous appendicitis and early appendicular perforation is more than 50%, especially if it measures more than 5 mm in diameter and is located at the base of the appendix [15] [25] [26]. thologists' analysis was a relevant contribution for the precise diagnostic.…”

Section: Discussionmentioning

confidence: 99%

Giant Appendicolith in Acute Exacerbation of Chronic Appendicitis: Case Report and Literature Review

Chávez¹,

Blanco²,

Chávez³

et al. 2017

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Right iliac fossa pain remains a challenge for clinicians, since it requires considering several differential diagnoses. Acute appendicitis continues to be one of the most important diagnoses to confirm or to rule out in acute abdominal pain, due to the associated morbidity and mortality. Currently, imaging studies contribute to increase diagnostic certainty, but sometimes reveal unexpected findings, which may further complicate the diagnosis and therapeutic decisions. We present the case of an unusual image finding in the right iliac fossa, a calcification suggestive of gallstone ileus, in the context of an acute abdomen with an unusual transoperative finding, whose definitive diagnosis by pathology, was also rare.

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“…9,10 Furthermore, faecaliths are associated with earlier and higher rates of perforation in children. 11 In addition, there is some evidence that the presence of an appendiceal faecalith may increase the risk of subsequent appendicitis.…”

Section: Discussionmentioning

confidence: 99%

Appendiceal faecaliths are associated with right iliac fossa pain

Grimes

Chin

Bailey

et al. 2010

annals

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Ann R Coll Surg Engl 2010; 92: 61-64 61There has been much debate in the literature as to whether a normal appendix should or should not be removed at diagnostic laparoscopy. On the one hand, it has been argued that a normal appendix should be removed as it may contain endoluminal inflammation, only apparent on histology.1 Removal of the appendix ensures that future presentations of right iliac fossa pain are not due to appendicitis. On the other hand, it has been argued that removal of a normal-looking appendix constitutes unnecessary surgery and risks complications such as stump leakage and is, therefore, not justified. 2,3We examined the role of the appendiceal faecalith as a possible cause of abdominal pain in people with histologically normal appendices. We hypothesise that faecaliths may cause intermittent abdominal symptoms by causing temporary luminal obstruction; this is relieved when the distal luminal pressure in the appendix becomes sufficient to expel the faecalith. Repeated cycles of obstruction-expulsion would thus cause recurrent abdominal symptoms, which would never amount to convincing appendicitis but cause repeated admissions and investigations. Thus removal of a normal appendix containing a faecalith would lead to resolution of symptoms. Patients and MethodsThe Hinchingbrooke Hospital histology database from 2003-2007 was searched for the keyword 'appendix'. Each individual pathology report was then analysed for its findings and a note made of all those that were histological normal and which did and did not contain a faecalith. We retrospectively studied the group of patients that had normal GENERAL SURGERY Ann R Coll Surg Engl

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Appendiceal fecalith is associated with early perforation in pediatric patients

Cited by 69 publications

References 20 publications

Association between the appendix and the fecalith in adults

Association between the appendix and the fecalith in adults

Giant Appendicolith in Acute Exacerbation of Chronic Appendicitis: Case Report and Literature Review

Appendiceal faecaliths are associated with right iliac fossa pain

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