Appendicolith

Dr. Kevin,
I have had right upper quadrant pain for approximately 2 years with negative CT scan, HIDA scan, ultrasounds,barium enema, and colonoscopy.  I recently had a CT scan which showed a appendicolith.  Could this be the cause of my pain?  How common are appendicoliths and what is done when one is found.  Thanks in advance for your help.
Nancy

[Kevin Pho, MD]

Surgeon has kindly addressed the major points regarding appendoliths - I agree with his comments.

You have clearly had a comprehensive workup for your right upper quadrant pain - including CT scan, HIDA scan (I assume with CCK stimulation to evaluate gall bladder function), ultrasounds and colonoscopy.

If an upper endoscopy hasn't been performed, this should be considered - peptic ulcers, inflammation of the esophagus or stomach can present as right upper quadrant pain.  I would also consider blood tests for H Pylori - which is a bacteria assicated with inflammation or ulcers that can be treated with antibiotics.

Followup with your personal physician is essential.

This answer is not intended as and does not substitute for medical advice - the information presented is for patient education only. Please see your personal physician for further evaluation of your individual case.

Thanks,
Kevin, M.D.

[surgeon]

appendicoliths are fairly common; if they cause a problem, it's by causing appendicitis which is nearly always an acute problem; meaning it starts, develops fever, vomitting, increasing pain in the right lower abdomen, and either is operated within a day or two, or gets worse and ruptures. So it's highly unlikely to be causing a chronic right upper abdominal pain. Appendicitis can occasionally be a recurring thing which resolves over and again without getting severe enough to be diagnosed and treated. When an appendicolith is discovered by accident on an xray, usually nothing is done; lots of people have them and never have problems. It's also believed that they may be expelled from the appendix with time. If you end up having surgery for some reason, or diagnostic laparoscopy, taking the appendix out at that time would make sense.

[nancypt2002]

Thank you for your comments!
Nancy

[nancypt2002]

Is Dr. Kevin on vacation?  If so, when can I expect an answer to my post.
Nancy

[mama410]

A related discussion, appendectomy was started.