The stranded stone: relationship between acute appendicitis and appendicolith

Saudi J Gastroenterol. 2009 Oct-Dec;15(4):258-60. doi: 10.4103/1319-3767.56106.

Abstract

Background/aim: To examine the relationship between acute appendicitis and the presence of an appendicolith in abdominal CT scans of patients attending emergency services.

Materials and methods: Abdominal CT scan reports were retrospectively reviewed for 267 patients through the PACS database. A 16-slices MDCT GE Light Speed scanner (Milwaukee WI) was used with a scanning protocol of 5 mm axial collimation and a pitch of 1.0, along with oral contrast material (Gastrografin 3.7% diatrizoate meglumine) and 140 mL of intravenous (IV) nonionic contrast material (Omnipaque). Particular attention was given to the study protocol, patients' age, and gender.

Statistical analysis: We used MS-EXCEL and SPSS version 12.0 to perform chi-square and Fisher's exact tests. Bookends and Papers, components in Mac OS X software, were used for literature reviews and the organization of results.

Results: Two hundred and sixty-seven abdominal CT scan reports were examined along side their respective images on a GE Centricity workstation. Thirty-four (12.7%) were labeled as acute appendicitis cases based on the CT findings and the rest were assigned other diagnoses. Twenty-six of the 267 CT scan reports were plain studies and 241 were contrast-enhanced scans. Less than half of the patients (123, 46.1%) were males and 144 (53.9%) were females. Thirteen males (48.1%) and 14 (51.9%) females were found to have an appendicolith. Only 3% in the <or= 11 years' age group, in contrast to 40% in the 11-20 years' age group, was diagnosed with appendicitis. The incidence in other age groups was as follows: 19% in the 21-30, 14% in the 31-40, 2.5% in the 41-50, 8% each in the 51-60 and 61-70, and none in the >or=71 years' age groups.

Conclusions: We conclude that the presence of an appendicolith i) has no particular predilection for gender or age, and ii) is not associated with a diagnosis of appendicitis.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Appendicitis / diagnostic imaging*
  • Cecal Diseases / diagnostic imaging*
  • Child
  • Female
  • Humans
  • Lithiasis / diagnostic imaging*
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Retrospective Studies
  • Tomography, X-Ray Computed