Ingested metallic foreign body lodged in the appendix

Abstract

An 8-year-old child ingested a metallic screw 3 months prior to admission. At laparotomy, the foreign body was found to be lodged inside the vermiform appendix, and was removed by appendicectomy.

INTRODUCTION

Appendicitis due to foreign bodies is very rare.[1–4] Stones, bullets, air gun pellets, pins, etc. have been described in the appendix. We present an 8-year-old boy who was found to have a metallic screw within the appendix.

CASE REPORT

An 8-year-old boy presented with a history of ingestion of a metallic screw about 3 months back, and otherwise asymptomatic. The physical examination and the laboratory investigations were within normal limits. Plain radiographs [Figure 1] of the abdomen showed a metallic screw in the right lower quadrant. At laparotomy, the screw was located inside the appendix. An appendicectomy was performed. The appendicular lumen was opened with a scalpel, and the screw was seen to be lodged inside it. The postoperative period was uneventful.

Figure 1.

Plain abdominal radiograph showing the metallic screw in the right iliac fossa

DISCUSSION

To the best of our knowledge, this is the third case of metallic screw as a foreign body lodged inside the appendix in a child.[5,6] Needles,[1,2] shotgun pellets,[4] bird shots,[7] hazelnut,[8] canine hair,[9] sand, and stones[10] have been reported to be causes of foreign body appendicitis in children. In a series of 217 cases of appendiceal foreign bodies reviewed by Balch and Silver,[3] pins were found to be the most common. The reported incidence of bowel perforation is less than 1%, especially with sharp, thin, pointed or long objects.[11]