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The 'wandering appendicolith'

Sonia L Betancourt1, Diana Palacio, George S Bisset

  • 1Thoracic Imaging, MD Anderson Cancer Center, The University of Texas, 1515 Holcombe Blvd., Unit 1478, Houston, TX, 77030-4008, USA, slbetancourt@mdanderson.org.

Pediatric Radiology
|December 7, 2014
PubMed

Insights

A retained appendicolith, a surgical complication, can migrate and cause delayed abscesses. This case highlights appendicolith migration into the chest cavity, leading to empyema requiring drainage and removal.

Area of Science:

  • Pediatric Surgery
  • Surgical Complications
  • Medical Imaging

Background:

  • Acute appendicitis is a frequent pediatric surgical emergency.
  • Appendectomy aims for complete appendix and appendicolith removal.
  • Retained appendicoliths can lead to delayed complications.

Observation:

  • An appendicolith, a calcified deposit, can be retained or expelled during appendectomy.
  • Ectopic appendicoliths may migrate, forming abscesses in various locations.
  • This case details an appendicolith migrating into the thoracic cavity, causing empyema.

Findings:

  • Appendicolith migration can present with delayed symptoms, weeks or months post-surgery.
  • Thoracic migration of an appendicolith resulted in empyema.
  • Successful management involved abscess drainage and appendicolith extraction.

Implications:

  • Highlights the importance of complete appendicolith removal during appendectomy.
  • Suggests considering retained appendicoliths in the differential diagnosis of delayed post-surgical abscesses.
  • Emphasizes the need for prompt diagnosis and intervention for ectopic appendicoliths.

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