A pin detected by ultrasonography within the normal appendix: prior to surgery, an impressive use of ultrasonography to localize an ingested foreign body exactly

Abstract

We present a 1-year-old boy who was asymptomatic and brought to the emergency room on suspicion of his having swallowed a pin. Confirmation of ingestion of the pin and its passage through the gut was achieved with abdominal radiography. The pin, which was followed with serial abdominal radiographs, was expected to leave the gastrointestinal tract, but was fixed to the right lower quadrant. When the pin had not passed after 10 days, and with increasing concern about the likelihood of perforation, ultrasonography was used to locate its exact position and allow surgical removal. Only a few cases involving the use of ultrasonography to reveal the exact location of an ingested foreign body prior to surgery have been reported ın the literature. This case presents an impressive example of the use of ultrasonography to reveal the intra-appendiceal location of an ingested foreign body, and to facilitate its surgical removal.

Keywords: Appendicitis; Foreign body; Ingestion; Ultrasound.

Fig. 1

The serial radiographs show a pin in the region of the right iliac fossa

Fig. 2

Longitudinal views. a The ultrasound scan of the appendix demonstrates the intraluminal position of the pin, with its head against the tip of the appendix. b The radiological illustration of the same image

Fig. 3

Transverse views. a The ultrasound scan of the appendix demonstrates the intraluminal position of the pin. b The radiological illustration of the same image

Fig. 4

The intraoperative picture shows the tip of the pin extending outward from the normal appendix