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Fishbone Perforated Appendicitis
Joey Chan Yiing Beh1, Anandswaroop Srinivas Uppaluri1, Beatrice Fang Ju Koh2
1Department of Diagnostic Radiology, Singapore General Hospital, Singapore.
Abstract:
Ingested foreign bodies tend to pass through the gastrointestinal tract without incidence, and vast majority of cases do not need intervention. Rarely, these foreign bodies drop into the appendix and not likely to re-enter the normal digestive tract. We describe a case of a 72-year-old male patient who presented with right iliac fossa pain of 3-day duration. Clinical examination suggested classic acute appendicitis. Blood test results revealed leukocytosis. Computed tomography of the abdomen and pelvis showed evidence of acute appendicitis and a linear hyperdensity (foreign body) perforating the appendix. The patient was managed successfully with prompt laparoscopic appendectomy and removal of the foreign body which was confirmed to be a fish bone measuring about 10mm. While imaging diagnosis of fishbone in the appendix has been published, reports are few. To the best of the author's knowledge, fishbone induced perforated appendicitis has been described only in 2 cases (including this case) in the literature.
Insights
A fish bone lodged in the appendix caused perforated appendicitis in a 72-year-old male. Prompt laparoscopic appendectomy successfully removed the foreign body and treated the condition.
Area of Science:
- Gastroenterology
- Surgical Pathology
Background:
- Ingested foreign bodies typically pass through the gastrointestinal tract without complications.
- Appendiceal perforation by foreign bodies is rare, with limited case reports in medical literature.
Observation:
- A 72-year-old male presented with symptoms consistent with acute appendicitis.
- Computed tomography revealed appendicitis with a perforating linear hyperdensity, later identified as a 10mm fish bone.
Findings:
- The patient underwent successful laparoscopic appendectomy with foreign body removal.
- This case represents one of only two documented instances of fish bone-induced perforated appendicitis.
Implications:
- Highlights the importance of considering ingested foreign bodies, such as fish bones, in the differential diagnosis of appendicitis.
- Emphasizes the efficacy of prompt surgical intervention in managing rare complications of foreign body ingestion.
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