Keywords:
Calcifications / Calculi, Abscess, Surgery, Drainage, CT, Interventional non-vascular, Abdomen
Authors:
C. Barry, C. Redmond, J. geraghty, D. P. Brophy; Dublin/IE
DOI:
10.1594/ecr2018/C-0816
Results
Between January 2009 and January 2016,
seven patients presented with a post appendicectomy retained appendicolith complication.
The patients’ characteristics are summarized in table 1 .
All patients had previously presented with acute appendicitis.
Six patients had undergone a laparoscopic appendicectomy,
one patient had a laparoscopic converted to open appendicectomy.
The mean time from appendicectomy to presentation was 1058 days (range 12-4745 days).
The presenting symptom of six of the patients was abdominal pain.
One patient presented with buttock pain. Initial blood investigations revealed a mean CRP of 124.9 mg/L (range 5-250.5 mg/L) and a mean WCC of 12.5 x 109/L (range 4.9-17.4 x109/L).
On CT the appendicoliths were demonstrated as an extra-luminal calcific focus of high attenuation with a mean size of 9mm (range 5-16).
Six patients had collections and one had pericaecal inflammatory change.
The location of collections were pericaecal (n=2),
retroperitoneal (n=1),
psoas (n=1),
subphrenic (n=1) and gluteal (n=1).
Management included percutaneous collection drainage (n=3),
percutaneous appendicolith retrieval (n=1),
open surgery (n=2),
and conservative management (n=1).
The mean number of re-presentations was 2 (range 1-4).
The mean length of stay per admission was 8.4 days (range 3-14).