Singhal Sanjeev, Singhal Anu, Mahajan Harsh, Prakash Brahm, Kapur Sunil, Arora Pankaj K, Tiwari Bishwanath, Sethi Punit
Department of Surgery, Northern Railway Central Hospital, New Delhi, India.
Department of Radiology, ESI Model Hospital and Post Graduate Institute of Medical Sciences and Research, New Delhi, India.
J Minim Access Surg. 2016 Apr-Jun;12(2):170-2. doi: 10.4103/0972-9941.178514.
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.
急性阑尾炎是全球最常见的外科急症之一。阑尾炎患者中阑尾结石的发生率存在相当大的差异。大多数阑尾结石患者无症状，且对急性阑尾炎无诊断特异性。然而，阑尾结石与穿孔及脓肿形成的相关性增加。阑尾结石相当常见，在普通人群中的发生率为3%，在阑尾炎病例中近10%。然而，直径超过2厘米的巨大阑尾结石极为罕见。计算机断层扫描（CT）显著提高了其术前诊断率。光谱分析的应用能在术前为我们提供结石成分的详细信息。我们报告一例年轻男性，术前通过非增强计算机断层扫描（NCCT）诊断为巨大磷酸钙镁铵阑尾结石。腹腔镜检查发现他有一个3厘米的结石及一个偶然发现的梅克尔憩室，并接受了阑尾切除术。本文介绍该病例独特大小的阑尾结石，并对相关文献进行综述。
