Calcified Appendiceal Phytobezoar Associated With Complicated Acute Appendicitis: A Case Report.
- 1General Surgery, Hospital Regional Valentín Gómez Farías, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Zapopan, MEX.
- 2Surgery, Hospital General Presidente Lazaro Cardenas del Rio, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Chihuahua, MEX.
- 3Pathology, Hospital Regional Valentín Gómez Farías, Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado (ISSSTE), Zapopan, MEX.
Abstract
An appendiceal phytobezoar is an uncommon intraluminal aggregate of indigestible plant material that may resemble a conventional appendicolith when calcified. We describe a 34-year-old woman who presented after approximately one day of severe right lower quadrant abdominal pain accompanied by nausea and vomiting. She was afebrile and hemodynamically stable but had localized peritoneal signs and neutrophilic leukocytosis. Plain radiographs showed a right lower quadrant radiopacity, and noncontrast computed tomography demonstrated a large appendiceal calcification with surrounding inflammatory changes. Emergency laparoscopy revealed a markedly enlarged, inflamed appendix and a localized purulent collection adjacent to an anatomically intact appendiceal base. Adhesiolysis and drainage of the collection were followed by laparoscopic appendectomy, securing the stump with two endoloops. The specimen measured 7.0 cm in length and 3.5 cm in maximum diameter and contained a 1.7 × 1.2 cm intraluminal concretion. Histopathology established suppurative and necrotizing acute appendicitis with ulceration and identified the concretion as a phytobezoar composed of vegetable fibers and dystrophic calcification. A Blake drain was removed on postoperative day 7 after drain output had ceased; subsequent follow-up remained favorable. This case illustrates the diagnostic limitation of labeling every calcified appendiceal concretion a fecalith and the value of radiologic-operative-pathologic correlation in symptomatic patients with apparently rapid progression to complicated appendicitis.
Related
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BibTeX
@article{fuentes2026calcified,
title = {{Calcified Appendiceal Phytobezoar Associated With Complicated Acute Appendicitis: A Case Report.}},
author = {Sergio Miguel Suárez Fuentes and María N Sandoval Arreola and Mauro A Cardenas and Soledad Merced Castro Olmedo and José J Cervantes De Anda and Claudia C Gómez Manzo and Jael Yamelis Gutierrez Luna and Daniel H Rodríguez Cárdenas and Diana Arias Galaviz and Juan de la Cruz Ramírez Jaimez},
journal = {Cureus},
year = {2026},
month = oct,
doi = {10.7759/cureus.117630},
url = {https://europepmc.org/article/MED/42999920},
note = {CC BY},
}
RIS
TY - JOUR
TI - Calcified Appendiceal Phytobezoar Associated With Complicated Acute Appendicitis: A Case Report.
AU - Sergio Miguel Suárez Fuentes
AU - María N Sandoval Arreola
AU - Mauro A Cardenas
AU - Soledad Merced Castro Olmedo
AU - José J Cervantes De Anda
AU - Claudia C Gómez Manzo
AU - Jael Yamelis Gutierrez Luna
AU - Daniel H Rodríguez Cárdenas
AU - Diana Arias Galaviz
AU - Juan de la Cruz Ramírez Jaimez
PY - 2026
DA - 2026/10/08
JO - Cureus
DO - 10.7759/cureus.117630
UR - https://europepmc.org/article/MED/42999920
AB - An appendiceal phytobezoar is an uncommon intraluminal aggregate of indigestible plant material that may resemble a conventional appendicolith when calcified. We describe a 34-year-old woman who presented after approximately one day of severe right lower quadrant abdominal pain accompanied by nausea and vomiting. She was afebrile and hemodynamically stable but had localized peritoneal signs and neutrophilic leukocytosis. Plain radiographs showed a right lower quadrant radiopacity, and noncontrast computed tomography demonstrated a large appendiceal calcification with surrounding inflammatory changes. Emergency laparoscopy revealed a markedly enlarged, inflamed appendix and a localized purulent collection adjacent to an anatomically intact appendiceal base. Adhesiolysis and drainage of the collection were followed by laparoscopic appendectomy, securing the stump with two endoloops. The specimen measured 7.0 cm in length and 3.5 cm in maximum diameter and contained a 1.7 × 1.2 cm intraluminal concretion. Histopathology established suppurative and necrotizing acute appendicitis with ulceration and identified the concretion as a phytobezoar composed of vegetable fibers and dystrophic calcification. A Blake drain was removed on postoperative day 7 after drain output had ceased; subsequent follow-up remained favorable. This case illustrates the diagnostic limitation of labeling every calcified appendiceal concretion a fecalith and the value of radiologic-operative-pathologic correlation in symptomatic patients with apparently rapid progression to complicated appendicitis.
SN - 2168-8184
ER -