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Appendiceal Fecalith Presenting as a Submucosal Cecal Polyp Removed During Colonoscopy
Kaitlin Payne1, Natalie Farha2, Erica Savage3
1Department of Internal Medicine, Cleveland Clinic, Cleveland, OH.
ACG Case Reports Journal
|February 15, 2023
Summary
Appendiceal fecaliths, rigid masses of feces, are linked to appendicitis. This case details the first discovery and removal of an appendiceal fecalith during colonoscopy in an asymptomatic patient.
Area of Science:
- Gastroenterology
- Colorectal Surgery
Background:
- Appendiceal fecaliths (stercoliths or coproliths) are hardened fecal masses.
- They are considered a primary cause of acute appendicitis and appendiceal intussusception in adults.
Observation:
- A submucosal mass was identified below the appendiceal orifice during colonoscopy.
- The patient was asymptomatic.
Findings:
- A neoplastic-appearing lesion at the appendiceal orifice was resected.
- Following resection, an appendiceal fecalith was extruded into the colonic lumen.
- This represents the first reported instance of an appendiceal fecalith discovered and fully removed during colonoscopy in an asymptomatic individual.
Implications:
- Colonoscopy can detect and remove appendiceal fecaliths, potentially preventing appendicitis.
- This case highlights an unusual presentation and successful endoscopic management of appendiceal fecaliths.
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