NYMC Faculty Publications

Role of the Faecolith in Modern-Day Appendicitis

Author Type(s)

Faculty

DOI

10.1308/003588413X13511609954851

Journal Title

Annals of the Royal College of Surgeons of England

First Page

48

Last Page

51

Document Type

Article

Publication Date

1-1-2013

Department

Surgery

Keywords

Adolescent, Adult, Aged, Appendectomy, Appendicitis, Child, Child, Preschool, Fecal Impaction, Humans, Infant, Middle Aged, Retrospective Studies, Tomography, X-Ray Computed, Young Adult

Disciplines

Medicine and Health Sciences

Abstract

INTRODUCTION: The prevailing view on appendicitis is that the main aetiology is obstruction owing to faecoliths in adults and lymphoid hyperplasia in children. Faecoliths on imaging studies are believed to correlate well with appendicitis.

METHODS: A retrospective chart review was conducted of 1,014 emergency appendicectomy patients between 2001 and 2011. Faecolith prevalence in adult and paediatric appendicectomy specimens with and without perforation was studied. The sensitivity and positive predictive value (PPV) of computed tomography (CT) for identifying faecoliths in the pathology specimen were examined.

RESULTS: Overall, faecoliths were found in 18.1% (178/986) of appendicitis specimens and 28.6% (8/28) of negative appendicectomies. Faecolith prevalence for positive cases was 29.9% (79/264) in paediatric patients and 13.7% (99/722) in adults (p

CONCLUSIONS: Faecolith prevalence is too low to consider the faecolith the most common cause of non-perforated appendicitis. Faecoliths are more prevalent in paediatric appendicitis than in adult appendicitis. Preoperative CT is an unreliable predictor of faecoliths in pathology specimens.

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