Appendicolith

Ray Ballinger, MD, PhD

Straub Clinic and Hospital

rballinger at straub.net

Abstract

11 y/o girl with abdominal pain, nausea and vomiting

Keywords

abdomen all ct appendix

History and Images

11 y/o girl with abdominal pain, nausea and vomiting for two days. White Blood Cell count: 16,000

click to enlarge click to enlarge

Findings

An appendicolith is identified in the proximal appendix with a fluid-filled distal appendix and free fluid in the cul-de-sac. A thickened and enhancing wall to the appendix is noted. The diameter exceeds 1 cm and there is stranding in the adjacent fat.

Diagnosis

Appendicolith with acute appendicitis

Confirmation:

Surgical Pathology

Discussion

The peak incidence of acute appendicitis is in the late childhood and adolescence. Clinical findings include generalized abdominal pain that later localized to the right lower quadrant, fever, loss of appetite and nausea. CT findings may include an enlarged appendix >7 mm diameter; an appendicolith; a thick, enhancing appendiceal wall; deformity or thickening of the apex of the cecum and stranding in the adjacent mesenteric fat. Peritoneal fluid may also be seen.

References

  1. Haaga et al. CT and MR Imaging of the Whole Body; 4th edition