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Helical computed tomographic incidence and characterization of appendoliths in 100 patients with appendicitis

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Abstract

This study was performed to determine the helical computed tomographic (CT) incidence and characteristics of appendoliths and the cecal bar sign of appendicitis. One hundred consecutive positive and 100 consecutive negative appendiceal CT scans were reviewed. Appendolith presence, number, size, shape, calcification and air pattern, density, and location were assessed, and the cecal bar, when present, was noted.

In 44% of positive appendiceal CT scans, there was one (30) or more (14) calcified appendolith(s), 8.0 mm in mean diameter. Characteristics included round (43.1%), oval (46.6%), or irregular (10.3%) shape; homogeneous (60.3%), rim (36.2%), or irregular (3.5%) calcifications; matrix air (15.5%); and Hounsfield unit (HU) densities (−161 HU to +1368 HU). Locations included proximal (36.2%), middle (44.8%), and distal (19.0%) third of the appendix. A cecal bar was present in 47.6% of proximal appendolith cases.

Appendoliths vary in size, shape, calcification and air patterns, density, and location and are present in 44% of positive appendicitis cases at helical CT. A cecal bar separates proximal appendoliths, when present, from cecal contrast medium.

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Rao, P.M., Rhea, J.T. & Novelline, R.A. Helical computed tomographic incidence and characterization of appendoliths in 100 patients with appendicitis. Emergency Radiology 4, 55–61 (1997). https://doi.org/10.1007/BF01508029

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