Ingested Foreign Bodies within the Appendix: A 100-Year Review of the Literature

Abstract

Background/Aim: Appendicitis and its complications remain a common problem affecting patients of all age groups. Foreign bodies are a rare cause of appendicitis. We tried to define potentially dangerous foreign bodies that may cause appendicitis and summarize general guidelines for their clinical management. Methods: A 100-year literature review including 256 cases of ingested foreign bodies within the appendix with emphasis on: (1) objects that are more prone to cause appendicitis or appendiceal perforation; (2) foreign bodies that are radiopaque and may be detected during follow-up with plain abdominal films, and (3) guidelines for clinical management. Results: Complications usually occur with sharp, thin, stiff, pointed and long objects. The majority of these objects are radiopaque. An immediate attempt should be made to remove a risky object by gastroscopy. If this fails, clinical follow-up with serial abdominal radiographs should be obtained. If the anatomical position of the object appears not to change and, most commonly, remains in the right lower abdominal quadrant, an attempt at colonoscopic removal is indicated. If this is unsuccessful, laparoscopic exploration with fluoroscopic guidance should be carried out to localize and remove the objects either by ileotomy, colotomy, or by appendectomy. Conclusion: Foreign bodies causing appendicitis are rare. However, if stiff or pointed objects get into the appendiceal lumen they have a high risk for appendicitis or perforation. These foreign bodies are almost always radiopaque.

Foreign Body in Appendix Presenting As Acute AppendicitisA Case Report

“…FBs in the appendix are uncommon but well described with an estimated prevalence of 0.0005 % [7,8]. FBs generally do not cause any complications and pass through the gastrointestinal tract (GIT) spontaneously within a week.…”

“…FBs generally do not cause any complications and pass through the gastrointestinal tract (GIT) spontaneously within a week. The complication rate of ingested FBs is estimated at less than 1 % [8]. A variety of objects are reported to be lodged in the appendix.…”

Can fruit seeds and undigested plant residuals cause acute appendicitis

“…Some of the fruit seeds swallowed are removed from the body naturally, while some of them can be the cause of appendicitis. There are reported cases of appendicitis which are caused by seeds of vegetables and fruits such as cocao, orange, melon, barley, oat, fig, grape, date, cumin, and nut [11][12][13][14] .…”

Appendicitis Caused by a Foreign Body of Dental Origin

“…In addition, a multitude of miscellaneous items have caused appendicitis, including stones, shells, solder, glass, enamel, coal, wood, nails, hair, mercury batteries, and the mercury end of a thermometer. 3,4 Very few cases of acute appendicitis have been reported to be caused by dental objects. [3][4][5] Most ingested foreign bodies pass through the gastrointestinal tract without incident.…”