Gastrointestinal Imaging

Appendicolithiasis

condition characterized by a concretion in the vermiform appendix. It is believed that by causing obstruction of the appendiceal lumen and subsequent accumulation of mucus appendicolithiasis may favour the development of appendicitis. Appendicoliths are found in 10% of patients with acute appendicitis, but they are seen more frequently in perforated appendicitis and in abscess formation. They are visible on plain films (Fig.1) as abnormal high attenuation shadows sometimes with a laminated appearance in the right lower quadrant. Their size varies usually between 1 and 2 cm. On ultrasound appendicoliths are visible as bright echogenic foci with distal acoustic shadowing. (Fig.2) Their exact position in relation to the organs is, however, best displayed on CT. They can be located in the appendiceal lumen or outside the lumen in an inflammatory mass or may lie freely in an abscess.

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Fig.1

Appendicolithiasis. Plain film of the abdomen revealing an oval radiopaque structure with multilayered pattern of calcification, projected on the right iliac bone.
Appendicolithiasis, Fig.1
Appendicolithiasis, Fig.2