Plain films of the abdomen will demonstrate a
fecalith in approximately 14% of patients with acute appendicitis.2 Localized ileus and dilated ileum may be evident.
In most patients with acute appendicitis, the primary pathology is luminal obstruction secondary to various causes such as
fecaliths, foreign bodies, lymphoid hyperplasia, and primary (carcinoid, adenocarcinoma, and lymphoma) and metastatic tumors (3).
Fecaliths are the usual cause of obstruction and less common causes are hypertrophy of lymphoid tissue, tumours, intestinal parasites, non-perforated acute appendicitis can be cured by appendectomy without any long recovery period, whereas delay in diagnosis and surgery in these patients can lead to dreaded complication like perforation and gangrene.
Appendiceal calculi and
fecaliths as indications for appendectomy.
The most frequent cause is generally accepted to be luminal obstruction, of which the most common causes are probably
fecaliths and hyperplasia of the lymphoid follicles.
The contents of the mass had similar appearance to the fecal material in distended bowel loops and some
fecaliths were also seenin the spinal canal suggesting fistulous connection (Figure 3).
The prevalence of appendiceal
fecaliths in patients with and without appendicitis.
Thus, in a lower-court case in which the plaintiff suffered a perforated bowel purportedly from the use of cholestyramine and codeine that resulted in severe constipation from huge
fecaliths, the doctor defendant was able to escape liability because the patient failed to exclude a barium enema procedure as the cause of the perforation.
Obstruction of the appendix caused by lymphoid hyperplasia and
fecaliths is considered to be the most common cause of acute appendicitis.
One is elevated intestinal pressure as a sequela of luminal obstruction caused by inflammation, mucosal hyperplasia, or intestinal lesions such as
fecaliths, endometriosis, diverticula, and polyps.
Thus, in a lower-court case in which the plaintiff suffered a perforated bowel purportedly from the use of cholestyramine and codeine that resulted in severe constipation from huge
fecaliths, the doctor defendant escaped liability because the patient fared to exclude a barium enema procedure as the cause of the perforation.
While calcified appendicoliths are frequently discussed with appendicitis, lymphoid hyperplasia and
fecaliths are also common causes of appendiceal obstruction.