April 1963

The Case of the Missing Fecalith

Author Affiliations

From the Department of Surgery, Madigan General Hospital, Tacoma, Wash.; Pressent address: Fresno County General Hospital, Fresno, Calif. (Capt Monfore).

Arch Surg. 1963;86(4):655-658. doi:10.1001/archsurg.1963.01310100139022

The subject of appendiceal fecalith has been discussed in the literature for many years. Wegeler14 first mentioned appendiceal stone in 1813. The first correct preoperative diagnosis of such was reported by Weisflog15 in 1906. Seilig11 introduced the term "coprolith" in 1908 and first discussed the condition in the American literature. In recent years many authors have reviewed numerous cases of appendiceal fecalith. The following case represents a unique complication to this entity.

Report of Case  The patient, a 22-year-old Caucasian male, was admitted to Madigan General Hospital with a seven-day history of progressive right lower quadrant pain, malaise, and fever. This was the first such episode. On physical examination he appeared acutely ill with fever and tachycardia and was in moderate abdominal distress. His abdomen was scaphoid. Bowel sounds were decreased. There were no palpable masses. There was marked, well-localized, direct tenderness and involuntary muscle spasm in

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