Dropped appendicolith

Retained appendicoliths, also called dropped or slipped appendicoliths, are appendicoliths that have been inadvertently left inside the peritoneal cavity following appendectomy.

Clinical presentation

Patients may be asymptomatic in some cases. Other cases may present with infective symptoms due to abscess formation. The interval between surgery and presentation varies considerably from days to even years .

Pathology

Retained appendicoliths may result from either a ruptured appendix or from being spilled during surgery.

Radiographic features

CT

Retained appendicoliths have the following appearances on CT :

• high density foci (the appendicolith) most commonly in the paracaecal region or Morison's pouch
• often associated abscess formation