A Case of Endoscopic Removal of a Giant Appendicolith Combined with Stump Appendicitis

Stump appendicitis is an acute inflammation of the residual appendix and is a rare complication after appendectomy. The physician should be aware of the possibility of stump appendicitis in patients with right lower abdominal pain after appendectomy so that delayed diagnosis and treatment can be prevented. Stump appendicitis is usually treated by surgical resection, and endoscopic treatment has not been reported previously. A 48-year-old man who had undergone appendectomy 35 years earlier presented to the hospital because of right lower quadrant discomfort. A computed tomography scan showed a large stone in the residual appendix. Colonoscopic findings revealed a large, smooth, protruding lesion at the cecum with a stone inside the appendiceal orifice. Endoscopic removal after incision of the appendiceal orifice was performed successfully.

A Case of Appendicolith Impressed as an Ureteral Calculus / 대한비뇨기과학회지

Despite the rather widespread interest in appendicoliths, we know of very few papers on this subject in the urological literature. If the roentgtnogram shows an opacity in the region of the right lower ureter, it becomes the responsibility of the urologist, general surgeon and radiologist to determine its correct diagnosis. Mark and Seelig have each reported a case of appendiceal stone with symptoms of ureteral colic, dysuria and an opacity, alone the course of the lower right ureter. The purpose of this paper is to report a case of appendical concretion which was diagnosed as an ureteral calculus preoperatively in our urology department. The patient was 57 years old woman who was admitted to St. Mary's Hospital because of pain on right lower quadrant associated with urological symptoms consisting of frequency, painful urination and microscopic hematuria. Radiological examination revealed an opaque shadow measuring 2.1 X 0.9 cm in the right lower quadrant along the ureteral course. On I. V. P. hydronephrotic change was noted on the right side associated with the opaque hadow, as seen in the K. U. B. Upon retrograde catheterization of the right ureter, obstruction was met at the site of apparent calcification and a catheter could not be passed above this area confirming an right ureteral calculus. At the operation, right lower ureter was found to be densely adhesive with retroperitoneum and calculus was not found in the ureter but in the appendix. Finally, appenectomy was performed through retroperitoneum and all of the adhesive areas were separated from the ureter.