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Article ; Online: Appendicolith appendicitis: should we be operating sooner? A retrospective cohort study.

Taib, A G / Kler, A / Prayle, M / Kanakalingam, D / Fani, M / Asaad, P

Annals of the Royal College of Surgeons of England

2023  Volume 106, Issue 3, Page(s) 237–244

Abstract: Introduction: Evidence suggests that delaying an appendicectomy for up to 24 hours does not increase the risk of complicated appendicitis. Appendicoliths are a risk factor for perforation. No study has explored the temporal relationship between ... ...

Abstract Introduction: Evidence suggests that delaying an appendicectomy for up to 24 hours does not increase the risk of complicated appendicitis. Appendicoliths are a risk factor for perforation. No study has explored the temporal relationship between appendicolith presence and time to perforation. In this retrospective cohort study, we hypothesise that the presence of an appendicolith confirmed on preoperative computerised tomography scan (pCT) leads to a shorter time to complicated appendicitis.
Methods: We undertook a retrospective single-centre study of patients admitted between 2018 and 2020. Inclusion criteria included: age ≥18 years, appendicitis confirmed on histopathology following an operation and a pCT scan. Complicated appendicitis was defined intraoperatively as an appendicular abscess, gangrenous or perforated appendix.
Results: Some 310 patients were included in the study. Forty-five per cent presented with complicated appendicitis (
Conclusions: Patients with an appendicolith appendicitis should be considered for an early appendicectomy. Future large-scale multicentre prospective studies are required to explore this further, perhaps informing future guidelines.
MeSH term(s) Humans ; Adolescent ; Appendicitis/complications ; Appendicitis/surgery ; Retrospective Studies ; Abscess ; Appendectomy/adverse effects ; Gangrene
Language English
Publishing date 2023-08-23
Publishing country England
Document type Journal Article
ZDB-ID 80044-2
ISSN 1478-7083 ; 0035-8843
ISSN (online) 1478-7083
ISSN 0035-8843
DOI 10.1308/rcsann.2023.0055
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