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CT-Guided Kopans Hookwire Placement for Preoperative Localization of an Appendicolith

Steven V. Lossef1

1 Department of Radiology, Children's National Medical Center, 111 Michigan Ave., NW, Washington, DC 20010.



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  		Fig. 1A —11-year-old girl with abscess in posterior subhepatic space containing calcified appendicolith. CT scan shows 8-cm abscess in posterior subhepatic space (Morison's pouch) containing 3- to 4-mm focal calcification, believed to be retained appendicolith.

 


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  		Fig. 1B —11-year-old girl with abscess in posterior subhepatic space containing calcified appendicolith. CT scan shows that abscess has resolved after percutaneous drainage but appendicolith persists.

 


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  		Fig. 1C —11-year-old girl with abscess in posterior subhepatic space containing calcified appendicolith. CT scan shows tip of 20-gauge needle has been advanced up to appendicolith via lower right posterior intercostal approach.

 


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  		Fig. 1D —11-year-old girl with abscess in posterior subhepatic space containing calcified appendicolith. CT scan shows barbed hook of Kopans modified hookwire (Cook) has been deployed adjacent to appendicolith.

 

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