Acute appendicitis is one of the most prevalent causes of an acute abdomen. Although the cause of appendicitis is not completely understood, the theory of luminal obstruction is a popular belief, with appendicoliths being a common etiology. While appendicoliths are quite common, giant appendicoliths >2 cm are rare. Although previous reports cite only two or three other occurrences of giant appendicoliths, we found at least 11 reported cases in the literature. We present a young male diagnosed preoperatively on computed tomography to have a large appendiceal mass of 2.2 cm. This case is presented for the rarity of giant appendicoliths along with a review of the literature.
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