• Rojan Adhikari, Prashant Simkhada, Deependra Mandal, Ashok Kunwar, and Saroj Prasad Dhital.
• Department of Surgery, Kathmandu Model Hospital, Adwait Marg, Kathmandu, Nepal.
• JNMA J Nepal Med Assoc. 2020 Apr 30; 58 (224): 255-257.

AbstractFecalith is a concretion of dry compact feces or hard stony mass of faeces in the intestinal tract. Though appendicular fecoliths are commonly encountered, caecal fecoliths are rare entities. Fecoliths are amenable to conservative management with laxatives and enemas but surgical management prevents recurrence. We present a case of 27 years old male who was diagnosed with acute appendicitis with peritonitis. He was intraoperatively diagnosed as gangrenous and perforated retrocaecal appendix with multiple small fecaliths and a large fecalith on cecum with perforation. Appendectomy and primary repair of caecal perforation done. Histological examination of perforated margin confirmed as an inflammatory lesion.

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