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Foreign body appendicitis: A case report and literature review
Mei-Chuan Liang1,2, Chung-Hsin Chang3,4, Sheng-Yang Huang5
1Department of Internal Medicine, Dalin Tzu Chi Hospital, Chiayi, Taiwan.
Insights
Foreign body ingestion in children, though rare, can cause appendicitis. A 2-year-old boy
Area of Science:
- Pediatric Gastroenterology
- Surgical Case Reports
Background:
- Foreign body ingestion is common in children aged 6 months to 6 years.
- Most ingested foreign bodies pass spontaneously.
- Appendix retention is rare but can cause appendicitis or perforation.
Purpose of the Study:
- To report a rare case of appendicitis caused by a retained foreign body.
- To highlight diagnostic and management strategies for such cases.
Main Methods:
- A case report of a 2-year-old boy with a screw retained in the GI tract for 2 months.
- Diagnosis confirmed by abdominal computed tomography (CT).
- Laparoscopic appendectomy performed due to prolonged foreign body presence and early acute appendicitis.
Main Results:
- A screw was found lodged near the ileocecal valve.
- Early acute appendicitis was confirmed pathologically.
- The patient recovered fully after laparoscopic appendectomy.
Conclusions:
- Appendicitis can be a complication of foreign body ingestion.
- Imaging (X-ray, CT) is crucial for diagnosis.
- Management includes endoscopic or surgical removal, including laparoscopic appendectomy.
Rationale:
Foreign body ingestion is more common in children than adults and occurs most frequently between the ages of 6 months and 6 years. While most foreign bodies pass spontaneously, retention in the appendix is rare and can lead to serious complications such as appendicitis or perforation.
Patient Concerns:
We report the case of a 2-year 10-month-old boy referred to our pediatric gastroenterology division due to a witnessed ingestion of a screw, which remained in the gastrointestinal tract for 2 months.
Diagnoses:
Abdominal computed tomography revealed a screw-shaped metallic foreign body located near the ileocecal valve, with mild dilatation of the small bowel.
Interventions:
Given the prolonged presence of the foreign body in the right lower abdomen, a laparoscopic appendectomy was performed. Pathology confirmed early acute appendicitis.
Outcomes:
The patient recovered uneventfully and was discharged on postoperative day 5 without complications.
Lessons:
Although rare, appendicitis can result from foreign body ingestion. Serial abdominal X-rays or abdominal 3-dimensional computed tomography scans can assist in diagnosis. Management options include endoscopic retrieval or surgical removal, such as laparoscopic appendectomy.
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