title: Association between the appendix and the fecalith in adults.
abstract: BACKGROUND
  We sought to determine the association between the presence of a fecalith and acute/nonperforated appendicitis, gangrenous/perforated appendicitis and the healthy appendix.
  
  
  METHODS
  We retrospectively analyzed appendectomies performed between October 2003 and February 2012. We collected data on age, sex, appendix histology and the presence of a fecalith.
  
  
  RESULTS
  During the study period, 1357 appendectomies were performed. Fecaliths were present in 186 patients (13.7%). There were 94 male (50.5%) and 92 female patients, and the mean age was 32 (range of 10-76) years. The fecalith rate was 13%- 16% and was nonexistant after age 80 years. The main groups with fecaliths were those with acute/nonperforated appendicitis (n = 121, 65.1%, p = 0.041) and those with a healthy appendix (n = 65, 34.9%, p = 0.003). The presence of fecaliths in the gangrenous/perforated appendicitis group was not significant (n = 19, 10.2%, p = 0.93). There were no fecaliths in patients with serositis, carcinoid or carcinoma.
  
  
  CONCLUSIONS
  Our data confirm the theory of a statistical association between the presence of a fecalith and acute (nonperforated) appendicitis in adults. There was also a significant association between the healthy appendix and asymptomatic fecaliths. There was no correlation between a gangrenous/perforated appendix and the presence of a fecalith. The fecalith is an incidental finding and not always the primary cause of acute (nonperforated) appendictis or gangrenous (perforated) appendicitis. Further research on the topic is recommended.
authors.affiliation: The Department of Surgery, General Hospital, Port-of-Spain, Trinidad, West Indies.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Ramdass
authors.affiliation: The Department of Surgery, General Hospital, Port-of-Spain, Trinidad, West Indies.
authors.forename: Quillan
authors.initials: Q
authors.lastname: Young Sing
authors.affiliation: The Department of Surgery, General Hospital, Port-of-Spain, Trinidad, West Indies.
authors.forename: David
authors.initials: D
authors.lastname: Milne
authors.affiliation: The Department of Surgery, General Hospital, Port-of-Spain, Trinidad, West Indies.
authors.forename: Justin
authors.initials: J
authors.lastname: Mooteeram
authors.affiliation: The Department of Surgery, General Hospital, Port-of-Spain, Trinidad, West Indies.
authors.forename: Shaheeba
authors.initials: S
authors.lastname: Barrow
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001062:Appendectomy; D001064:Appendicitis / Q000453:epidemiology* / Q000601:surgery; D001065:Appendix / Q000473:pathology; D002648:Child; D004487:Edema / Q000473:pathology; D005244:Fecal Impaction / Q000453:epidemiology*; D005260:Female; D005734:Gangrene; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012704:Serous Membrane / Q000473:pathology; D014300:Trinidad and Tobago / Q000453:epidemiology; D055815:Young Adult