Retained appendicolith: Some things work themselves out
Management of perforated appendicitis has been debated for decades, remaining controversial today. Data is scarce regarding the approach to retained appendicolith after appendectomy.A 14-year-old girl presented with perforated appendicitis and an extraluminal appendicolith. IV antibiotics were initi...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2022-06-01
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| Series: | Journal of Pediatric Surgery Case Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213576622000872 |
| _version_ | 1811306202457440256 |
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| author | Megan Cibulas Oliver Lao |
| author_facet | Megan Cibulas Oliver Lao |
| author_sort | Megan Cibulas |
| collection | DOAJ |
| description | Management of perforated appendicitis has been debated for decades, remaining controversial today. Data is scarce regarding the approach to retained appendicolith after appendectomy.A 14-year-old girl presented with perforated appendicitis and an extraluminal appendicolith. IV antibiotics were initiated and drain placed until resolution of intraabdominal abscess. The drain was removed, and she was discharged on oral antibiotics. Ten days later she developed pain and purulent drainage from the drain site and was found to have a reaccumulated collection, so antibiotics were restarted, and she improved. Weeks later interval laparoscopic appendectomy ensued; the appendix was inflamed, and purulent fluid was noted in the pelvis.She initially recovered until multiple abscess recurrences, first temporized by percutaneous drainage, and subsequently by 6 weeks of antibiotics. Finally, workup of progressive right hip pain and swelling revealed a subcutaneous collection containing a shadowing echogenic lesion, consistent with the appendicolith from initial CT.Incision and drainage yielded pus and a 12 mm brown calcified mass; packing was placed. She was discharged on amoxicillin and continued wound care. Pathologic evaluation described a mass of calcified degenerated vegetable matter and food particles consistent with an appendicolith. Two years later she is without recurrent symptoms. |
| first_indexed | 2024-04-13T08:41:20Z |
| format | Article |
| id | doaj.art-9754a5eb96f0413783c7ddfbaf630eda |
| institution | Directory Open Access Journal |
| issn | 2213-5766 |
| language | English |
| last_indexed | 2024-04-13T08:41:20Z |
| publishDate | 2022-06-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of Pediatric Surgery Case Reports |
| spelling | doaj.art-9754a5eb96f0413783c7ddfbaf630eda2022-12-22T02:53:54ZengElsevierJournal of Pediatric Surgery Case Reports2213-57662022-06-0181102260Retained appendicolith: Some things work themselves outMegan Cibulas0Oliver Lao1Corresponding author.; Joe DiMaggio Children's Hospital, Division of Pediatric Surgery, 1005 Joe DiMaggio Dr, Hollywood, FL, 33021, USAJoe DiMaggio Children's Hospital, Division of Pediatric Surgery, 1005 Joe DiMaggio Dr, Hollywood, FL, 33021, USAManagement of perforated appendicitis has been debated for decades, remaining controversial today. Data is scarce regarding the approach to retained appendicolith after appendectomy.A 14-year-old girl presented with perforated appendicitis and an extraluminal appendicolith. IV antibiotics were initiated and drain placed until resolution of intraabdominal abscess. The drain was removed, and she was discharged on oral antibiotics. Ten days later she developed pain and purulent drainage from the drain site and was found to have a reaccumulated collection, so antibiotics were restarted, and she improved. Weeks later interval laparoscopic appendectomy ensued; the appendix was inflamed, and purulent fluid was noted in the pelvis.She initially recovered until multiple abscess recurrences, first temporized by percutaneous drainage, and subsequently by 6 weeks of antibiotics. Finally, workup of progressive right hip pain and swelling revealed a subcutaneous collection containing a shadowing echogenic lesion, consistent with the appendicolith from initial CT.Incision and drainage yielded pus and a 12 mm brown calcified mass; packing was placed. She was discharged on amoxicillin and continued wound care. Pathologic evaluation described a mass of calcified degenerated vegetable matter and food particles consistent with an appendicolith. Two years later she is without recurrent symptoms.http://www.sciencedirect.com/science/article/pii/S2213576622000872AppendicolithFecalithAppendicitis |
| spellingShingle | Megan Cibulas Oliver Lao Retained appendicolith: Some things work themselves out Journal of Pediatric Surgery Case Reports Appendicolith Fecalith Appendicitis |
| title | Retained appendicolith: Some things work themselves out |
| title_full | Retained appendicolith: Some things work themselves out |
| title_fullStr | Retained appendicolith: Some things work themselves out |
| title_full_unstemmed | Retained appendicolith: Some things work themselves out |
| title_short | Retained appendicolith: Some things work themselves out |
| title_sort | retained appendicolith some things work themselves out |
| topic | Appendicolith Fecalith Appendicitis |
| url | http://www.sciencedirect.com/science/article/pii/S2213576622000872 |
| work_keys_str_mv | AT megancibulas retainedappendicolithsomethingsworkthemselvesout AT oliverlao retainedappendicolithsomethingsworkthemselvesout |