title: Resolution of appendiceal colic following migration of an appendicolith.
abstract: The presence of an appendiceal fecalith should not be considered as a categorical sign of acute appendicitis. The fecalith may, however, be responsible for abdominal pain--right lower quadrant tenderness without associated appendicitis, i.e. appendiceal colic. When a patient presents with right lower quadrant abdominal tenderness, abdomino-pelvic computerized tomography (CT) may establish this diagnosis by demonstrating the presence of the appendicolith but without evidence of appendiceal inflammation or infection. Spontaneous migration of the appendicolith may result in cure. In this previously unpublished clinical case, the CT demonstrates the spontaneous passage of the appendicolith, which coincided in time with the resolution of the abdominal pain syndrome. When a patient presents with typical symptoms of appendiceal colic and CT findings of an appendicolith without appendicitis, appendectomy will certainly relieve the pain. But if the stone passes spontaneously, the need for appendectomy is debatable, particularly in a high-risk patient.
authors.affiliation: Service de chirurgie viscérale, hôpital Saint-Camille, 94360 Bry-sur-Marne, France. Electronic address: jacques.hernigou@gmail.com.
authors.forename: J
authors.initials: J
authors.lastname: Hernigou
authors.affiliation: Service d'hépato-gastroentérologie, hôpital Saint-Camille, 94360 Bry-sur-Marne, France.
authors.forename: B
authors.initials: B
authors.lastname: Condat
authors.affiliation: Service d'hépato-gastroentérologie, hôpital Saint-Camille, 94360 Bry-sur-Marne, France.
authors.forename: A
authors.initials: A
authors.lastname: Giaoui
authors.affiliation: Service de chirurgie viscérale, hôpital Saint-Camille, 94360 Bry-sur-Marne, France.
authors.forename: A
authors.initials: A
authors.lastname: Charlier
mesh_terms: D015746:Abdominal Pain / Q000175:diagnosis / Q000209:etiology; D001064:Appendicitis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy; D003085:Colic / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy; D003937:Diagnosis, Differential; D005244:Fecal Impaction / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000628:therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed / Q000379:methods
keywords: Appendiceal colic; Appendicitis; Appendicolith