A Case of Appendicolith Impressed as an Ureteral Calculus

Lim, Soo Kil; Oh, Se Im; Kim, Kee Soo

Abstract

Despite the rather widespread interest in appendicoliths, we know of very few papers on this subject in the urological literature. If the roentgtnogram shows an opacity in the region of the right lower ureter, it becomes the responsibility of the urologist, general surgeon and radiologist to determine its correct diagnosis. Mark and Seelig have each reported a case of appendiceal stone with symptoms of ureteral colic, dysuria and an opacity, alone the course of the lower right ureter. The purpose of this paper is to report a case of appendical concretion which was diagnosed as an ureteral calculus preoperatively in our urology department. The patient was 57 years old woman who was admitted to St. Mary's Hospital because of pain on right lower quadrant associated with urological symptoms consisting of frequency, painful urination and microscopic hematuria. Radiological examination revealed an opaque shadow measuring 2.1 X 0.9 cm in the right lower quadrant along the ureteral course. On I. V. P. hydronephrotic change was noted on the right side associated with the opaque hadow, as seen in the K. U. B. Upon retrograde catheterization of the right ureter, obstruction was met at the site of apparent calcification and a catheter could not be passed above this area confirming an right ureteral calculus. At the operation, right lower ureter was found to be densely adhesive with retroperitoneum and calculus was not found in the ureter but in the appendix. Finally, appenectomy was performed through retroperitoneum and all of the adhesive areas were separated from the ureter.