Appendicitis Research Today is a free monthly online journal that collates and summarizes the latest research about Appendicitis, including details on symptoms, surgery, causes, treatment.

Outcomes in 74 patients with an appendicolith who did not undergo surgery: is follow-up imaging necessary?

Rabinowitz CB, Egglin TK, Beland MD, Mayo-Smith WW

Department of Diagnostic Imaging, Brown Medical School, Rhode Island Hospital, 593 Eddy Street, Providence, RI, 02903, USA, chadrabbi@yahoo.com.

The objective of this study was to report the clinical outcome of patients with an appendicolith on computed tomography (CT) who did not undergo appendectomy on initial presentation. Reports from 45,901 abdominal CT examinations performed between March 2000-March 2004 containing the words "appendicolith" or "fecalith" were identified. Patients with appendicoliths not initially undergoing appendectomy were followed to assess re-presentation with abdominal pain ultimately requiring appendectomy. Seventy-four patients had an appendicolith on CT report, were discharged without surgery, and had clinical follow-up. Fifty-two of 74 (70%) patients had no appendiceal symptoms, were given an alternate diagnosis, and did not return with appendicitis. Twenty-two of 74 (30%) patients were discharged without acute appendicitis but with possible appendiceal symptoms. Five of these 22 (23%) patients returned with pathologically proven acute appendicitis, and all had possible appendiceal symptoms at initial presentation. An appendicolith may be a marker of increased risk for appendicitis but is not an indication for appendectomy.

Published 4 July 2007 in Emerg Radiol, 14(3): 161-5.
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