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Acute appendicitis with four appendicoliths: a first case report in the English literature

Patrick Lafleche1, Yagan Pillay2

  • 1Enhanced Surgical Skills Resident, Victoria Hospital, Prince Albert, Canada.

Journal of Surgical Case Reports
|July 25, 2020
PubMed

Insights

Multiple appendicoliths, or hardened deposits in the appendix, are rare and can indicate severe appendicitis. Emerging evidence suggests elective appendicectomy may be justified even in asymptomatic cases.

Area of Science:

  • Gastroenterology
  • Surgical Pathology

Background:

  • Appendicoliths are calcifications within the appendix.
  • Multiple or large appendicoliths (>5 mm) are associated with complicated appendicitis.

Observation:

  • This case presents an extremely rare instance of multiple appendicoliths within a single appendix.
  • No correlation with appendicular malignancy was identified.

Findings:

  • The presence of multiple and large appendicoliths is linked to severe appendicitis, perforation, and gangrene.
  • The surgical management of asymptomatic patients with appendicoliths remains controversial.

Implications:

  • Emerging evidence supports considering elective appendicectomy for asymptomatic patients with appendicoliths.
  • This case highlights the diagnostic and management challenges posed by rare appendiceal pathologies.
Keywords:
AppendicectomyElective appendicectomyMultiple appendicoliths

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