stranded stone: relationship between acute appendicitis and appendicolith

ABSTRACT

To examine the relationship between acute appendicitis and the presence of an appendicolith in abdominal CT scans of patients attending emergency services. 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. 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. 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 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. 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