[Abscesses after appendectomy due to intraoperative retaining of fecalith]

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M Hörmann1, S Kreuzer, P Sacher

  • 1Universitätsklinik für Radiodiagnostik, Abteilung chirurgische Facher, AKH Wien, Osterreich. marcus.hoermann@akh-wien.ac.at

Rofo : Fortschritte Auf Dem Gebiete Der Rontgenstrahlen Und Der Nuklearmedizin
|September 26, 2001
PubMed

Insights

Fecaliths, hard stool masses, can lead to appendicitis, abscesses, and perforation in children. Early imaging detection of fecaliths is crucial for surgical planning and preventing complications like retained fecaliths after appendectomy.

Area of Science:

  • Pediatric Radiology
  • Gastrointestinal Surgery

Background:

  • Fecaliths are associated with increased risk of acute appendicitis, abscess formation, and perforation.
  • Preoperative radiological evaluations are increasingly utilized, but immediate surgery is common for suspected perforation in children.

Purpose of the Study:

  • To report and discuss imaging findings and implications of fecaliths in children with acute appendicitis.
  • To highlight the importance of detecting fecaliths in preoperative imaging.

Main Methods:

  • Retrospective review of four pediatric patients (mean age 9 years) with acute appendicitis and fecaliths.
  • Sonography and plain radiography were used for diagnosis, with all patients undergoing imaging after readmission.

Main Results:

  • Fecaliths were initially diagnosed in 3 of 4 patients.
  • All 4 patients experienced recurrent abdominal pain and required readmission.
  • Sonography and plain radiography demonstrated escaped fecaliths, confirmed surgically.

Conclusions:

  • The role of imaging in acute appendicitis should extend beyond diagnostic yield of cross-section techniques.
  • Detecting fecaliths prompts a more thorough intraoperative search.
  • Radiologists must be aware of retained fecaliths as a cause of post-appendectomy abscess formation.
Abstract

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