Acute appendicitis caused by foreign body ingestion

Abstract

Foreign bodies usually do not cause complications and pass through the gastrointestinal tract spontaneously. Usually endoscopic intervention is recommended within 24 hours. Cases of acute appendicitis caused by foreign bodies are very rare. In our case, we experienced successful endoscopic and surgical treatment of a patient with ingestion of razor blade and some unrecognizable foreign bodies. A 22-year-old soldier was admitted with a small quantity of hematemesis and epigastric pain. We performed emergent endoscopy and successfully removed several foreign bodies. After 17 days, we performed appendectomy to remove the remaining foreign body and to relieve the symptoms. There is no doubt that endoscopic intervention is definitely useful method to remove foreign bodies. If there is no spontaneous drainage of the foreign body from the appendix, an appendectomy must be considered to remove the foreign body and prevent surgical complications such as appendicitis, periappendiceal abscess, and perforation.

Keywords: Appendectomy; Appendicitis; Foreign bodies.

Fig. 1. Abdomen plain x-ray reveals several pieces of foreign bodies.

Fig. 2. Abdominal CT finding reveals multiple, scattered metal fragments in stomach (A), appendix (B), ascending colon (C), and sigmoid colon (D).

Fig. 3. Esophagogastroduodenoscopy finding reveal multiple foreign bodies in stomach. (A) Metallic foreign bodies in stomach. (B) A white and black plastic foreign body in stomach.

Fig. 4. Abdominal CT finding reveals a remained round foreign body in appendix, dilated appendix.

Fig. 5. Macroscopic findings of specimen show a mild dilated appendix (7 mm in diameter), mild redness around midportion of appendix and a round shaped metallic foreign body.