A clinical and radiographic study of appendiceal fecaliths: a review of the literature and report of seven cases.

Annals of Surgery (Impact Factor: 7.19). 04/1960; 151:374-8.
Source: PubMed
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    ABSTRACT: The role of appendicectomy after the resolution of appendicular mass is debatable. A study was conducted to evaluate whether surgical and pathological features of the excised appendices favor the operation in the quiescent period. During a 60-month period, 59 patients were admitted in our unit with a diagnosis of appendicular mass and were treated initially with conservative management. Five patients failed to respond to this management and they were operated on immediately. Fifty-four patients recovered fully, and relatives were advised to bring them back to the hospital for appendicectomy on a scheduled date after 6 weeks. Fifteen of 54 (27.7%) patients did not return, but the other 7 came back because they had symptoms of recurrent appendicitis. The remaining 32 patients underwent appendicectomy as scheduled. The surgical findings and pathological features of excised appendices showed various abnormalities. Considering these features it could be concluded that delayed appendicectomy is unjustified in patients with absent appendix or with its lumen obliterated, whereas the other remaining patients who harbored normal, thickened, fibrotic, transected, stump, and appendix with chronic inflammation or containing fecal casts would benefit from operation. Because we have no method to date to distinguish between these variants "in situ" delayed appendicectomy seems beneficial for all the patients who respond well to the initial management of appendicular mass.
    Journal of Pediatric Surgery 04/2000; 35(3):424-7. DOI:10.1016/S0022-3468(00)90206-9 · 1.31 Impact Factor
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    The American journal of roentgenology, radium therapy, and nuclear medicine 07/1968; 103(2):351-3. DOI:10.2214/ajr.103.2.351
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    ABSTRACT: Seventy pediatric patients with histories of recurrent crampy abdominal pain, right lower quadrant tenderness, and proven filling defects or distention of the appendix on radiographs, have been subjected to appendectomy. Inspissated fecal material was found within the appendix in 72.8% of such children. Fecal material was found in only 12.9% of 155 normal appendices and in 33.8% of 530 acutely inflamed appendices. It is postulated that inspissated fecal material acts as a foreign body of the appendix, leading to intermittent obstruction and distention of the appendix--appendiceal colic. An 86% correlation between the appendiceal filling defects seen on radiographs and the inspissated fecal material found within the appendix at operation has been noted. Ninety-six per cent of these 70 children had been relieved of their recurrent abdominal pain by appendectomy. Appendiceal colic characterized by crampy abdominal pain, right lower quadrant tenderness, and appendiceal filling defects appears to be a veritable and verifiable diagnosis.
    Annals of Surgery 12/1980; 192(5):687-93. DOI:10.1097/00000658-198011000-00016 · 7.19 Impact Factor


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