Jun Man Kim MD, Presenter: Nothing to Disclose

Ok Hwa Kim MD, Abstract Co-Author: Nothing to Disclose

Kyung Hee Kang, Abstract Co-Author: Nothing to Disclose

To determine the significance of appendicolith detected on CT by comparing the initial and follow-up CT.

CT scans obtained for abdominal pain assessment in 1676 patients under the age of 15 years were reviewed retrospectively. Apparent CT features of appendicitis with or without appendicolith were present in 307 patients and they subsequently received operation. These patients were excluded from the study. Appendicolith within normal appendix was found in 44 out of the remaining 1369 patients and these 44 were enrolled in this study. Clinical follow-up was conducted by contacting each patient’s parents over the telephone with a questionnaire. With the consent of the parents, non-enhanced follow-up CT scans were obtained in the limited area from the lower abdomen to pelvis.

Out of 44 patients, 8 were lost on the follow-up. None of the remaining 36 patients developed any symptoms suggesting appendicitis. None had any history of visiting the hospital for abdominal pain thereafter. Seven patients refused follow-up CT examination and thus CT scans were obtained in 29 of 36 patients. The mean interval between the initial and follow up CT examination was 16 months (range: 2-39 months). In comparison to the initial examinations, follow up CT scans revealed persistently visible appendicolith in 8 of 29 patients (27.6%) and remaining 21 showed no appendicolith.

Appendicolith disappeared spontaneously in most of the study population and the patients with residual appendicolith presented no evidence of appendicitis on clinical and follow up CT imaging.

The appendicolith may disappear spontaneously and the presence of appendicolith alone is not sufficient to diagnose appendicitis on CT.

Kim, J, Kim, O, Kang, K, Outcome of Appendicolith Revealed on CT in Patients without Appendicitis: An Analysis on Clinical Consequence and Limited Follow-up CT.  Radiological Society of North America 2007 Scientific Assembly and Annual Meeting, November 25 - November 30, 2007 ,Chicago IL. http://archive.rsna.org/2007/5005503.html