A bizarre foreign body in the appendix: A case report

Abstract

Foreign bodies are rare causes of appendicitis and, in most cases, ingested foreign bodies pass through the alimentary tract asymptomatically. However, ingested foreign bodies may sometimes remain silent within the appendix for many years without an inflammatory response. Despite the fact that cases of foreign-body-induced appendicitis have been documented, sharp and pointed objects are more likely to cause perforations and abscesses, and present more rapidly after ingestion. Various materials, such as needles and drill bits, as well as organic matter, such as seeds, have been implicated as causes of acute appendicitis. Clinical presentation can vary from hours to years. Blunt foreign bodies are more likely to remain dormant for longer periods and cause appendicitis through obstruction of the appendiceal lumen. We herein describe a patient presenting with a foreign body in his appendix which had been swallowed 15 years previously. The contrast between the large size of the foreign body, the long clinical history without symptoms and the total absence of any histological inflammation was notable. We suggest that an elective laparoscopic appendectomy should be offered to such patients as a possible management option.

Endoscopic Management of Foreign Bodies in the Gastrointestinal Tract: A Review of the Literature

“…Appendicitis secondary to foreign object ingestion has been reported in cases of swallowed air gun pellets, razorblades, screws, and other metallic objects [30]. Rounded objects may lay dormant in the appendix for a long time asymptomatically and suddenly present as right lower quadrant abdominal pain years later, requiring surgical intervention [31]. …”

Acute appendicitis caused by foreign body ingestion

“…The clinical presentation can vary from hours to years [ 9 ]. Antonacci et al [ 2 ] suggested the formation of a fecal coat around a foreign body probably can control development of inflammatory process, therefore, beginning and severity of inflammation of appendix may various.…”

“…Foreign body ingestion occurs more than one hundred thousand patients annually in the United States [ 1 ]. More than 80% of these patients are children and 98% of these patients are accidental [ 2 ]. Foreign bodies usually do not cause complications and pass through the gastrointestinal tract spontaneously, but bleeding, perforation, erosion, and ulceration of gastrointestinal tract can occur by sharp or pointed foreign bodies.…”

Dental extraction from an appendix: a case report and review of the literature

“…Ingested foreign bodies are estimated to be radiographically detectable in as many as 80% of cases, supporting the use of CT, a modality widely used for the investigation of suspected appendicitis . There are suggestions in the literature that known foreign bodies may not indicate a change in management for uncomplicated appendicitis, with laparoscopic appendicectomy still considered the gold standard . Greater controversy exists in the management of cases in which conservative management would otherwise be considered, such as in delayed presentation or when associated with a soft tissue mass .…”