Case of a Giant Appendicolith

Appendicoliths are calcified deposits located within the appendiceal lumen, usually measuring less than 1 cm in diameter. Appendicoliths greater than 2 cm in the largest diameter are uncommon and referred to as giant appendicoliths. Generally, patients with giant appendicoliths are asymptomatic, with these being detected incidentally on X-ray or computed tomography (CT). However, the presence of appendicoliths has been shown to be associated with an increased risk of developing appendicitis and is associated with more severe appendicitis. There is an increased incidence of appendicoliths in retrocecal appendices. This case report is of an adult male patient who presented with a three-day history of right iliac fossa pain, nausea, and decreased appetite. CT of the abdomen and pelvis showed acute appendicitis secondary to a calcified 3.1 cm giant appendicolith. Open appendicectomy was subsequently performed as the patient’s financial constraints hindered a laparoscopic approach. The clinical outcome was successful with no postoperative complications, and the patient was discharged the following day. The patient was reviewed six weeks post-laparotomy with no complaints and was discharged from the surgical outpatient clinic.