Re-assessing the role of the fecalith in acute appendicitis in adults: Case report, case series and literature review

Nguyen Tran, Valerie Sue Emuakhagbon, Bradford T. Baker, Sergio Huerta

Research output: Contribution to journalReview articlepeer-review

Abstract

Appendicitis in adults is thought to occur because of luminal obstruction from a fecalith. We present a unique case of a patient who had her entire appendiceal lumen occupied by a fecalith (5.0 cm long) but had no appendicitis. We reviewed the records of 257 veterans who underwent surgical intervention at our institution for the management of acute appendicitis. Fecaliths occurred in 15.6% of patients. At laparotomy, 20.6% had a perforated appendix; pathology showed fecaliths in 20.8% of specimens. A review of the literature inclusive of 25 series showed fecaliths in 33.3% of patients with a normal appendix, 23.5% of patients with acute appendicitis and 24.9% with perforated appendicitis. These data show that appendicitis is not a common cause of fecalith obstruction in adults.

Original languageEnglish (US)
Article numberrjaa543
JournalJournal of Surgical Case Reports
Volume2021
Issue number1
DOIs
StatePublished - Jan 1 2021

ASJC Scopus subject areas

  • Surgery

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