ArticleBJS open2024
Impact of an appendicolith and its characteristics on the severity of acute appendicitis.
Article in BJS open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
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Who cites it
9 citing papers in PubMed.
- One year follow up outcomes of endoscopic retrograde appendicitis treatment for symptomatic appendicoliths.iScience · 2026Article
- A novel CT-based scoring system for appendicoliths and its prognostic value in acute appendicitis: a retrospective cohort study.Emergency radiology · 2026Article
- Appendicolith detection in dual-energy CT of adult acute appendicitis: comparing portovenous phase and virtual noncontrast with true noncontrast images.Abdominal radiology (New York) · 2026Article
- Removal of an Incidental Appendicolith Impacting the Appendiceal Orifice During Colonoscopy Screening.ACG case reports journal · 2026Article
- Appendicolith and inflammatory burden in pediatric acute appendicitis: an independent association.Pediatric surgery international · 2026Article
- Development and internal validation of a risk-stratification model for complicated appendicitis in the elderly: a retrospective comparative study.BMC gastroenterology · 2026Article
- Building and validating machine learning models to predict appendiceal perforation during conservative treatment of fecalith-associated appendicitis: a 20-algorithm multicenter retrospective analysis.Scientific reports · 2026Article
- Appendicitis.Nature reviews. Disease primers · 2025Review
- Update on the Diagnosis and Treatment of Acute Appendicitis.Journal of clinical medicine · 2024Article
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Authors and funding
11 authors.
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Abstract
backgroundAntibiotics have been reported as an efficient and safe treatment option for uncomplicated acute appendicitis without an appendicolith diagnosed using computed tomography (CT). The aim of this study was to assess the association of a CT-diagnosed appendicolith and its characteristics with appendicitis severity.
methodsA large prospective patient cohort with suspected acute appendicitis enrolled between April 2017 and November 2018 was retrospectively reviewed. The initial analysis evaluated the association of a CT-diagnosed appendicolith with complicated acute appendicitis; then, based on the availability of CT images, a subset of patients was analysed for the correlation of appendicolith characteristics with appendicitis severity. The final appendicitis assessment (uncomplicated or complicated-including perforation, gangrene, an abscess, or a tumour) was determined for all patients.
resultsOut of 3512 eligible patients, 3085 patients with appendicitis were selected and 380 patients with an appendicolith and with a CT image available for reassessment were included. Out of the 3085 patients with CT-diagnosed acute appendicitis, 1101 (35.7%) patients presented with both acute appendicitis and an appendicolith and, out of these, 519 (47.1%) had complicated acute appendicitis. In the patients without an appendicolith (1984 patients), 426 (21.5%) had complicated appendicitis (P < 0.001). Re-evaluation of CT images for 380 patients showed that a larger appendicolith diameter (OR = 1.15 (95% c.i. 1.06 to 1.25); P < 0.001), appendicolith location at the base of the appendix (55.1% versus 44.9%; P = 0.008), and heterogeneous appendiceal wall enhancement around the appendicolith (68.4% versus 31.6%; P < 0.001) were associated with an increased risk of complicated acute appendicitis.
conclusionThe presence of an appendicolith in patients with acute appendicitis is correlated with the risk of complicated appendicitis. This risk is further increased by a larger appendicolith diameter or appendicolith location at the base of the appendix.
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