The Stranded Stone: Relationship Between Acute Appendicitis and Appendicolith

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 ≤ 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 ≥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.