Case contribution: Dr Radhiana Hassan


  • A 57 years old male
  • Presented with per rectal bleeding
  • Clinical examination reveals internal haemorrhoid
  • Previous history of haemorrhoidectomy

Abdominal radiograph findings:

  • A rounded density seen at right iliac fossa region (yellow arrow)
  • Lamilated appearance noted of this focal density.
  • No dilated bowel loops.
  • Normal distribution of bowel loops
  • No obvious soft tissue mass lesion

CT scan findings:

  • The appendix is prominent with slightly thickened wall
  • The calcification is seen within wall of proximal appendix
  • No abnormal mass lesion at the bowel loops

Progress of patient:

  • Colonoscopy performed with scope examination done until caecum
  • There is bulging of appendicular lumen
  • Biopsy was taken at terminal ileum; HPE report was normal
  • Stapler granuloma at rectum from previous operation
  • Patient was managed conservatively


  • Appendicolith is a calcified deposit within the appendix
  • Seen in overall 10% of patients
  • May be an incidental finding on abdominal radiograph or CT scan
  • Present in a large number of children with appendicitis
  • A high attenuation stone at right iliac fossa on xray and CT scan
  • Up to 25% show laminated appearance
  • On ultrasound it will appear as lesion with acoustic shadow
Author: radhianahassan