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Association between the appendix and the fecalith in adults
Michael J Ramdass1, Quillan Young Sing1, David Milne1
1The Department of Surgery, General Hospital, Port-of-Spain, Trinidad, West Indies.
Canadian Journal of Surgery. Journal Canadien De Chirurgie
|November 27, 2014
Summary
Fecaliths are associated with acute, nonperforated appendicitis and healthy appendices in adults. Their presence does not correlate with gangrenous or perforated appendicitis, suggesting they are often incidental findings.
Area of Science:
- Gastroenterology
- Surgical Pathology
- Clinical Diagnostics
Background:
- Fecaliths, hardened stool masses, are hypothesized to contribute to appendicitis.
- Understanding the association between fecaliths and appendiceal pathology is crucial for diagnosis and treatment.
Purpose of the Study:
- To investigate the relationship between fecalith presence and different appendiceal conditions: acute/nonperforated appendicitis, gangrenous/perforated appendicitis, and healthy appendices.
Main Methods:
- Retrospective analysis of 1357 appendectomies performed between October 2003 and February 2012.
- Data collected included patient age, sex, appendix histology, and the presence or absence of a fecalith.
Main Results:
- Fecaliths were found in 13.7% of appendectomies (186 patients).
- A significant association was observed between fecaliths and acute/nonperforated appendicitis (65.1%) and healthy appendices (34.9%).
- No significant association was found between fecaliths and gangrenous/perforated appendicitis (10.2%). Fecaliths were absent in cases of serositis, carcinoid, or carcinoma.
Conclusions:
- The study confirms a statistical association between fecaliths and acute, nonperforated appendicitis in adults.
- A significant association also exists between fecaliths and asymptomatic, healthy appendices.
- Fecaliths appear to be incidental findings and not consistently the primary cause of acute or severe appendicitis, warranting further investigation.
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