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A 'Bit' of Appendicitis: A Case of a Foreign Object in the Adult Appendix

Elizabeth Packard1, Andrew Groff1, Zainab Shahid2

  • 1Internal Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, USA.

Cureus
|August 1, 2019
PubMed

Insights

Appendicitis, a common surgical emergency, can be fatal if untreated. This case highlights foreign body ingestion as a rare cause, emphasizing prophylactic appendectomy to prevent severe complications.

Area of Science:

  • Gastroenterology and Surgical Emergencies
  • Pathophysiology of Inflammation

Background:

  • Appendicitis is the most frequent abdominal surgical emergency, with potential for severe outcomes like abscess, peritonitis, or death if untreated.
  • The primary theory involves luminal obstruction of the vermiform appendix, leading to ischemia, bacterial translocation, and transmural inflammation.
  • Common causes include lymphoid hyperplasia secondary to infection, presenting with gradual onset.

Observation:

  • Rarer etiologies of appendiceal obstruction, such as parasitic infiltration, fibrous bands, carcinoid syndrome, and foreign body ingestion, often present with atypical symptoms.
  • These atypical presentations complicate diagnosis and increase the risk of complications.
  • A rare case of appendicitis caused by a foreign body lodged distally in the appendix is presented.

Findings:

  • Foreign body ingestion represents an uncommon but significant cause of appendicitis.
  • Atypical symptomatology associated with rare causes can delay diagnosis and treatment.
  • Prompt diagnosis and management are crucial for preventing severe complications.

Implications:

  • This case underscores the importance of considering foreign body ingestion in the differential diagnosis of appendicitis, especially with atypical presentations.
  • Prophylactic appendectomy may be a valuable strategy to mitigate severe complications associated with foreign body-induced appendicitis.
  • Further research into the mechanisms and diagnostic challenges of rare appendicitis etiologies is warranted.
Keywords:
appendectomyappendicitisdrill bitforeign bodyperforation

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