[Lithiasis of the vermiform appendix. Remarks on a clinical case]

The authors present a case of a 36 year old male, admitted with a 3 year history of cramping abdominal pain, fever, and transient finding of a right lower quadrant mass. The abdominal roentgenogram revealed a large opacity located on the right side of the fifth lumbar segment. The patient underwent laparotomy: an enlarged appendix was removed. The specimen had 4 calculi completely obstructing the lumen of the appendix. The diameter of calculi were 0.5 (in 3 instances) and 3 cm. The case herein described is rather uncommon, due to: 1) the rarity of multiple appendiceal calculi; 2) the size of the larger stone; 3) the inconstant finding of right lower quadrant mass; 4) the non development of acute appendicitis. Differential diagnosis involved several diseases presenting with palpable mass of the lower quadrant of the abdomen and/or laminated densities at the plain abdominal roentgenogram.