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BACKGROUND: Appendicitis is the most common cause of acute
abdomen. The diagnosis of appendicitis can be easy when it
presents with the classical symptoms or is very challenging when
present with atypical presentation. Around 20-30% of patients
operated on for appendicitis have appendicolithiasis.
Appendicolithiasis are usually small in size, and are called giant
when more than 2cm in size.
CASE DETAIL: A 36 years old man was referred from a district
hospital with a diagnosis of cecal cancer. His complaints were
right lower quadrant (RLQ) abdominal mass of 03 months and
pain of 18 months duration. Colonoscopy was normal but
abdominal CT showed a RLQ mass with a dense radio-opaque
shadow at its center.
CONCLUSIONS: Giant appendicolith is a rare condition. A high
index of suspicion and careful review of imaging findings is the
key in early diagnosis and improved patient outcomes.