{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,10]],"date-time":"2026-06-10T11:33:47Z","timestamp":1781091227548,"version":"3.54.1"},"reference-count":32,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2021,1,30]],"date-time":"2021-01-30T00:00:00Z","timestamp":1611964800000},"content-version":"vor","delay-in-days":29,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2021,1,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Appendicitis in adults is thought to occur because of luminal obstruction from a fecalith. We present a unique case of a patient who had her entire appendiceal lumen occupied by a fecalith (5.0 cm long) but had no appendicitis. We reviewed the records of 257 veterans who underwent surgical intervention at our institution for the management of acute appendicitis. Fecaliths occurred in 15.6% of patients. At laparotomy, 20.6% had a perforated appendix; pathology showed fecaliths in 20.8% of specimens. A review of the literature inclusive of 25 series showed fecaliths in 33.3% of patients with a normal appendix, 23.5% of patients with acute appendicitis and 24.9% with perforated appendicitis. These data show that appendicitis is not a common cause of fecalith obstruction in adults.<\/jats:p>","DOI":"10.1093\/jscr\/rjaa543","type":"journal-article","created":{"date-parts":[[2020,11,26]],"date-time":"2020-11-26T04:11:09Z","timestamp":1606363869000},"source":"Crossref","is-referenced-by-count":14,"title":["Re-assessing the role of the fecalith in acute appendicitis in adults: case report, case series and literature review"],"prefix":"10.1093","volume":"2021","author":[{"given":"Nguyen","family":"Tran","sequence":"first","affiliation":[{"name":"University of Texas Southwestern Medical School, Dallas, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valerie-Sue","family":"Emuakhagbon","sequence":"additional","affiliation":[{"name":"Department of Surgery, VA North Texas Health Care System, Dallas, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bradford T","family":"Baker","sequence":"additional","affiliation":[{"name":"Department of Pathology, VA North Texas Health Care System, Dallas, TX, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sergio","family":"Huerta","sequence":"additional","affiliation":[{"name":"University of Texas Southwestern Medical School, Dallas, TX, USA"},{"name":"Department of Surgery, VA North Texas Health Care System, Dallas, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2021,1,29]]},"reference":[{"key":"2021020403262227500_ref1","article-title":"Current Surgial Therapy","author":"Cameron","year":"2011","journal-title":"10th edn"},{"key":"2021020403262227500_ref2","first-page":"321","article-title":"Perforating inflammation of the vermiform appendix","volume":"92","author":"Fitz","year":"1886","journal-title":"Am J Med Sci"},{"key":"2021020403262227500_ref3","first-page":"789","article-title":"Obstruction of the appendix lumen in relation to pathogenesis of acute appendicitis","volume":"149","author":"Arnbjornsson","year":"1983","journal-title":"Acta Chir Scand"},{"key":"2021020403262227500_ref4","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1308\/003588413X13511609954851","article-title":"Role of the faecolith in modern-day appendicitis","volume":"95","author":"Singh","year":"2013","journal-title":"Ann R Coll Surg Engl"},{"key":"2021020403262227500_ref5","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1016\/j.jss.2017.08.021","article-title":"Risk of appendicitis in patients with incidentally discovered appendicoliths","volume":"221","author":"Khan","year":"2018","journal-title":"J Surg Res"},{"key":"2021020403262227500_ref6","doi-asserted-by":"crossref","first-page":"394","DOI":"10.1016\/S0735-6757(96)90058-3","article-title":"The myth of the fecalith","volume":"14","author":"Maenza","year":"1996","journal-title":"Am J Emerg Med"},{"key":"2021020403262227500_ref7","doi-asserted-by":"crossref","first-page":"309","DOI":"10.1007\/s11605-009-1094-1","article-title":"Predictive factors for negative outcomes in initial non-operative management of suspected appendicitis","volume":"14","author":"Shindoh","year":"2010","journal-title":"J Gastrointest Surg"},{"key":"2021020403262227500_ref8","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1016\/j.surg.2018.04.027","article-title":"Outcomes of appendectomy in elderly veteran patients","volume":"164","author":"Renteria","year":"2018","journal-title":"Surgery"},{"key":"2021020403262227500_ref9","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1097\/00000658-198507000-00013","article-title":"The prevalence of appendiceal fecaliths in patients with and without appendicitis. A comparative study from Canada and South Africa","volume":"202","author":"Jones","year":"1985","journal-title":"Ann Surg"},{"key":"2021020403262227500_ref10","first-page":"63","article-title":"Obstruction of appendix vermiformis causing acute appendicitis. An experimental study in the rabbit","volume":"148","author":"Pieper","year":"1982","journal-title":"Acta Chir Scand"},{"key":"2021020403262227500_ref11","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/S1092-9134(00)90011-X","article-title":"The pathology of acute appendicitis","volume":"4","author":"Carr","year":"2000","journal-title":"Ann Diagn Pathol"},{"key":"2021020403262227500_ref12","doi-asserted-by":"crossref","first-page":"362","DOI":"10.1001\/archsurg.1939.01200150041003","article-title":"Appendicitis with especial reference to pathogenesis, bacteriology and healing","volume":"39","author":"Bowers","year":"1939","journal-title":"Arch Surg"},{"key":"2021020403262227500_ref13","doi-asserted-by":"crossref","first-page":"13","DOI":"10.3109\/00016924309135637","article-title":"Roentgenologic examination of acute appendicitis","volume":"24","author":"Steinert","year":"1943","journal-title":"Acta Radiol"},{"key":"2021020403262227500_ref14","first-page":"265","article-title":"71,000 human appendix specimens. 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