title: Giant appendicolith: Rare finding in a common ailment.
abstract: Acute appendicitis is one of the commonest surgical emergencies worldwide. There is considerable variation in prevalence of appendicoliths with appendicitis. Most of the patients with appendicoliths are asymptomatic and they are not pathognomic for acute appendicitis. However, appendicoliths show increased association with perforation and abscess formation. Appendicolith are quite common, being present in 3% of general population and in nearly 10% cases of appendicitis. However, giant appendicoliths measuring over 2 centimeters (cms) are extremely rare. Computed Tomography (CT) has increased their pre-operative diagnosis considerably. Use of spectral analysis can give us the details of composition of the stone pre-operatively. We present a young male diagnosed pre-operatively on Non-Contrast Computed Tomography (NCCT) to have a giant calcium struvite appendicolith. On laparoscopy he had a 3 cm stone and an incidental Meckel's diverticulum and underwent appendectomy. The case is presented for the unique size of the appendicolith alongwith review of literature.
authors.affiliation: Department of Surgery, Northern Railway Central Hospital, New Delhi, India.
authors.forename: Sanjeev
authors.initials: S
authors.lastname: Singhal
authors.affiliation: Department of Radiology, ESI Model Hospital and Post Graduate Institute of Medical Sciences and Research, New Delhi, India.
authors.forename: Anu
authors.initials: A
authors.lastname: Singhal
authors.affiliation: Department of Radiology, Mahajan Imaging Centre, New Delhi, India.
authors.forename: Harsh
authors.initials: H
authors.lastname: Mahajan
authors.affiliation: Department of Surgery, Northern Railway Central Hospital, New Delhi, India.
authors.forename: Brahm
authors.initials: B
authors.lastname: Prakash
authors.affiliation: Department of Surgery, Northern Railway Central Hospital, New Delhi, India.
authors.forename: Sunil
authors.initials: S
authors.lastname: Kapur
authors.affiliation: Department of Surgery, Northern Railway Central Hospital, New Delhi, India.
authors.forename: Pankaj K
authors.initials: PK
authors.lastname: Arora
authors.affiliation: Department of Surgery, Northern Railway Central Hospital, New Delhi, India.
authors.forename: Bishwanath
authors.initials: B
authors.lastname: Tiwari
authors.affiliation: Department of Radiology, Mahajan Imaging Centre, New Delhi, India.
authors.forename: Punit
authors.initials: P
authors.lastname: Sethi
keywords: Acute appendicitis; giant appendicolith; laparoscopic appendectomy