A Giant Fecolith in Pelvic Acute Appendicitis: A Case Report

Abstract

Calcified deposits in the lumen of the appendix are called appendicolith. The diameter of these appendicoliths is usually smaller than 1 cm. A giant Appendicolith is a rare faecolith larger than 2 cm. Usually, these giant appendicoliths are diagnosed by radiological investigations (such as computed tomography or X-rays of the abdomen) as the patients with giant appendicoliths have no complaints. Obstruction of the appendicular lumen by appendicolith not only increases the risk of acute appendicitis but also increases the risk of complications such as abscess formation and perforation. Our case report is for a 23-year-old gentleman who presented to the casualty with a history of right iliac fossa pain, nausea, vomiting, loose motion and loss of appetite for 2 days. A radio-opaque shadow in the pelvis was seen in an X-ray of the abdomen.  An intravenous (IV) contrast-based abdominal computed tomography (CT) revealed acute appendicitis with a calcified 2.5 cm giant appendicolith. laparoscopic appendicectomy was performed. The patient was doing well postoperatively with no postoperative complications, and the patient was discharged home after one day. Two weeks later, the patient was reviewed in the surgical outpatient clinic (SOPD) with no complaints.