The radio-opaque appendicolith--its significance in clinical practice

Four cases are reported, in whom radiologically opaque appendiceal coproliths (appendicoliths) were recognised on plain abdominal radiographs. These were undertaken for diagnostic purposes, in patients with right-sided abdominal pain, in whom the diagnosis was not immediately apparent. The pathology, radiological features, and clinical significance of the phenomenon are discussed, and the association of appendicoliths with appendiceal perforation and gangrene is stressed. The fact that clinical signs and symptoms of acute appendicitis are often misleading and sometimes minimal, even in the presence of severe local peritoneal infection is of importance to physicians as well as surgeons.