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August 6, 1973

Retained Fecalith as Late Complication of Appendectomy

Author Affiliations

Mary Imogene Bassett Hospital Cooperstown, NY

JAMA. 1973;225(6):639. doi:10.1001/jama.1973.03220330051028

To the Editor.—  An unrecognized, retained appendiceal, fecalith giving rise to an intra-abdominal abscess seven years after appendectomy, is a rare and unexpected postoperative complication. Only four similar cases have been recorded.1-4

Report of a Case.—  A 22-year-old white man was admitted to the hospital for the first time in December 1970 with a threeday history of malaise, fever, and persistent, dull aching right upper quadrant abdominal pain. He denied nausea and vomiting, jaundice, acholic stools, melena, or diarrhea.His earlier medical history was of considerable interest. In 1963 he underwent an appendectomy at a community hospital. The operative finding was acute, perforated appendicitis. He made an uneventful recovery, resuming oral feedings on the third day, and he was discharged on the seventh postoperative day. He remained totally asymptomatic during the next four years.In September 1967 he was admitted to a community hospital with fever and right upper