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Elmansi Abdalla HE, Nour HM, Qasim M, Magsi AM, Sajid MS. Appendiceal Foreign Bodies in Adults: A Systematic Review of Case Reports. Cureus 2023; 15:e40133. [PMID: 37425596 PMCID: PMC10329456 DOI: 10.7759/cureus.40133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2023] [Indexed: 07/11/2023] Open
Abstract
Adults can accidentally swallow foreign bodies (FBs) with food. In rare occasions, these can lodge in the appendix lumen causing inflammation. This is known as foreign body appendicitis. We conducted this study to review different types and management of appendiceal FBs. A comprehensive search on PubMed, MEDLINE, Embase, Cochrane Library and Google Scholar was performed to detect appropriate case reports for this review. Case reports eligible for this review included patients above 18 years of age with all types of FB ingestion causing appendicitis. A total of 64 case reports were deemed to be eligible for inclusion in this systematic review. The patient mean age was 44.3 ± 16.7 years (range, 18-77). Twenty-four foreign bodies were identified in the adult appendix. They were mainly lead shot pellet, fishbone, dental crown or filling, toothpick, and others. Forty-two percent of the included patients presented with classic appendicitis pain, while 17% were asymptomatic. Moreover, the appendix was perforated in 11 patients. Regarding modalities used for diagnosis, computed tomography (CT) scans confirmed the presence of FBs in 59% of cases while X-ray only managed to detect 30%. Almost all of the cases (91%) were treated surgically with appendicectomy and only six were managed conservatively. Overall, lead shot pellets were the most common foreign body found. Fishbone and toothpick accounted for most of the perforated appendix cases. This study concludes that prophylactic appendicectomy is recommended for the management of foreign bodies detected in the appendix, even if the patient is asymptomatic.
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Affiliation(s)
| | - Hussameldin M Nour
- Department of Digestive Disease and General Surgery, Royal Sussex County Hospital, Brighton, GBR
| | - Muhammad Qasim
- Department of Digestive Disease and General Surgery, Royal Sussex County Hospital, Brighton, GBR
| | - Abdul Malik Magsi
- Department of Digestive Disease and General Surgery, Royal Sussex County Hospital, Brighton, GBR
| | - Muhammad S Sajid
- Department of Digestive Disease and General Surgery, Royal Sussex County Hospital, Brighton, GBR
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2
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Iliopsoas abscess secondary to ingested metallic foreign body in a child. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2022. [DOI: 10.1016/j.epsc.2022.102499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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3
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Fuller MY, Leino DG, Reyes-Múgica M, Kovach AE, Velázquez Vega JE, Caltharp S, Bhatti T, Gonzalez RS. Ingested Foreign Bodies Can Cause Appendicitis and Perforation: A Multi-Institutional Case Series. Pediatr Dev Pathol 2022; 25:499-503. [PMID: 35400217 DOI: 10.1177/10935266221083188] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
INTRODUCTION Appendicular foreign bodies are a rare, under-described cause of appendicitis. We performed this study to determine the varied causes and consequences of foreign-body appendicitis. METHODS On retrospective review of the pathology archives of seven institutions, we identified 56 appendix specimens containing a foreign body (defined as ingested, non-digestible material). We recorded the type of foreign body, patient age and sex, and other findings, as available. RESULTS Mean patient age was 7.7 years (range: 1 day-18 years). The foreign bodies included hair, plant material, magnets, other metallic material, BB pellets, foreign material not otherwise specified, and other miscellaneous objects. Of 48 cases with available clinical information, 31 patients presented with abdominal pain, and 22 were preoperatively diagnosed as having appendicitis/appendicular inflammation. Seven patients had appendiceal perforation (13%). The foreign body was grossly identified in 34/47 cases with available gross descriptions. Twenty-seven cases had an identifiable foreign body microscopically; 10 were associated with giant cell reaction. DISCUSSION Hair and plant materials were the most common foreign objects found in the appendix; they often cause mucosal damage and giant cell reaction. Metallic objects were less common. Although appendicular foreign bodies in children are rare and sometimes asymptomatic, they may lead to perforation.
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Affiliation(s)
- Maren Y Fuller
- Texas Children's Hospital/Baylor College of Medicine, 3989Houston, TX, USA
| | | | | | - Alexandra E Kovach
- Monroe Carell Jr. Children's Hospital at Vanderbilt University Medical Center, 21629Nashville, TN, USA.,Children's Hospital Los Angeles, Los Angeles, CA, USA
| | | | | | - Tricia Bhatti
- Children's Hospital of Philadelphia, 6567Philadelphia, PA, USA
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Brennan ZJ, Young G, Packer K. A Tooth Decaying in the Appendix: An Unusual Cause of Appendicitis. Cureus 2022; 14:e24086. [PMID: 35573519 PMCID: PMC9098261 DOI: 10.7759/cureus.24086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 04/12/2022] [Indexed: 11/05/2022] Open
Abstract
Appendicitis is a very common indication for surgery, although in recent years uncomplicated cases have often been managed with antibiotics. In this case, we discuss a patient who presented to the emergency department with a case of seemingly uncomplicated acute appendicitis. Physical exam, history, and imaging indicated that this was due to an ingested foreign body, specifically a dental crown, that had impacted the appendix. In cases of ingested foreign bodies, antibiotics are not an appropriate treatment for appendicitis and all cases should be treated surgically if the patient will tolerate surgery. A thorough history and physical exam, as well as imaging when indicated, can assist in the assessment of such patients.
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Affiliation(s)
- Zachary J Brennan
- Surgery, Michigan State University College of Osteopathic Medicine, East Lansing, USA
| | - Grace Young
- Surgery, A.T. Still University-Kirksville College of Osteopathic Medicine, Kirksville, USA
| | - Kyle Packer
- General Surgery, Brookwood Baptist Health, Jasper, USA
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Lloyd A, Abd Elwahab S, Boland M, Elfadul A, Hill A, Power C. Acute complicated appendicitis caused by an ingested toothpick – A case report. Int J Surg Case Rep 2022; 92:106872. [PMID: 35259701 PMCID: PMC8902606 DOI: 10.1016/j.ijscr.2022.106872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/16/2022] [Accepted: 02/22/2022] [Indexed: 11/15/2022] Open
Abstract
Introduction and importance Acute appendicitis is one of the most common presentations to the emergency department, particularly in young adults. A combination of clinical suspicion, inflammatory blood markers and imaging modalities such as ultrasound and CT are used for its definitive diagnosis. Early detection and intervention are paramount to reduce morbidity and mortality. Laparoscopic appendicectomy is the current gold standard in the management of appendicitis, especially if complicated according to EAES guidelines. There are few documented cases in the literature of acute appendicitis secondary to foreign body ingestion. On account of this, there are currently no guidelines for its management. Our literature review highlights the importance of surgical management of foreign body acute appendicitis. Case presentation This case report describes the rare presentation of acute complicated appendicitis caused by an ingested toothpick in a 64 year old woman. The patient was admitted with a 3 day history of lower abdominal pain, localizing to the right iliac fossa with raised inflammatory markers. CT imaging reported acute complicated appendicitis. Laparoscopic appendicectomy was performed during which a toothpick was seen protruding through the appendiceal wall. Post operatively the patient was treated with IV antibiotics for 5 days prior to discharge. Clinical discussion Due to the rare nature of foreign body appendicitis there are no specific guidelines on the respective surgical approach. A literature review showed that in the setting of foreign body appendicitis, surgical intervention is paramount with no scope for conservative management. Conclusion Surgical approach is based on the clinical judgement and skillset of the operating surgeon. Remember foreign body ingestion as a cause of appendicitis Management of foreign body appendicitis is surgical intervention. Open vs laparoscopic approach depends on the surgeons clinical judgement, preference and skillset.
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AbiMansour JP, Sathi T, Law R. Quit screwing around: magnetic retrieval of an appendiceal foreign body. VideoGIE 2022; 7:233-234. [PMID: 35693038 PMCID: PMC9174078 DOI: 10.1016/j.vgie.2022.02.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Jad P AbiMansour
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
| | - Thanmay Sathi
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
| | - Ryan Law
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
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Alyaseen H, Alnosair A, Alghanim M, Almusawi A, Cordoba C. Diamonds in the appendix. ANNALS OF PEDIATRIC SURGERY 2022. [DOI: 10.1186/s43159-021-00146-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
An uncommon cause of appendicitis is the entrapment of ingested foreign objects in the appendix. Although a rare event, it could remain asymptomatic for a prolonged time. The presence of foreign bodies in the gastrointestinal tract has a high potential for complications, in particular if sharp or large enough in size to cause obstruction. However, most often an ingested foreign object would be eliminated in the stool. Rarely, it may reside in the appendix depending on various factors such as the nature of the ingested body and the appendiceal peristaltic movements.
Case presentation
We report a case of abdominal pain due to a diamond earring trapped in the appendix for 2 years. A plain X-ray of the abdomen confirmed the diagnosis which prompted a laparoscopic appendectomy resulting in resolution of symptoms.
Conclusion
The initial presentation of an ingested foreign object can be similar to signs of symptoms of acute appendicitis and the patient must be monitored for several days to follow the trajectory of the foreign body in order to prevent complications. Even though the incidence is more common among the pediatric population, vigilance among adults should also be undertaken with a history of ingesting a foreign object, as this case demonstrates the importance of keeping a high index of suspicion when encountering such cases.
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Sacks MA, Goodman LF, Khan FA, Radulescu A. Unusual cause of appendicitis: Orthodontic wire. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2021. [DOI: 10.1016/j.epsc.2021.101909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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9
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Cheng He R, Nobel T, Greenstein AJ. A case report of foreign body appendicitis caused by tongue piercing ingestion. Int J Surg Case Rep 2021; 81:105808. [PMID: 33887850 PMCID: PMC8050728 DOI: 10.1016/j.ijscr.2021.105808] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 03/18/2021] [Indexed: 12/03/2022] Open
Abstract
Foreign body ingestion is a rare cause of appendicitis. Heavy, rigid, long, or sharp objects are more likely to lodge within the appendix. Laparoscopic appendectomy should be performed for foreign body appendicitis to ameliorate the risk of complications.
Introduction Foreign body ingestion is an uncommon clinical problem in healthy adults. Furthermore, it is even less common for an ingested foreign body to cause any obstructive symptoms within the gastrointestinal tract. Presentation of case Here, we describe an unusual case of acute appendicitis induced by a tongue piercing that was ingested by a 32-year-old woman with a recent history of endotracheal intubation. Abdominal X-ray revealed metallic foreign bodies in the right lower quadrant. The foreign bodies remained in place on serial X-rays despite bowel preparation and they were not visualized on colonoscopy. Computed tomography (CT) of the abdomen and pelvis confirms the location of the foreign body within the appendix. Laparoscopic appendectomy was performed without complications and the tongue piercing was recovered within the lumen of the resected appendix. Discussion Foreign body ingestion is a rare cause of appendicitis. Most ingested foreign bodies spontaneously pass through the gastrointestinal tract within a week. However, in rare instances, the foreign body becomes lodged in the appendix, often resulting in appendicitis. Conclusion In patients with appendicitis secondary to foreign body ingestion, we suggest surgical management to reduce the risk of peritonitis, perforation, and abscess formation.
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Affiliation(s)
- Rossana Cheng He
- Department of Surgery, Mount Sinai Hospital, 1468 Madison Ave, New York, NY 10029, USA.
| | - Tamar Nobel
- Department of Surgery, Mount Sinai Hospital, 1468 Madison Ave, New York, NY 10029, USA.
| | - Alexander J Greenstein
- Departments of Surgery and Health Policy, Mount Sinai Hospital, 1468 Madison Ave, New York, NY 10029, USA.
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Ong LWL, Kabir T, Kam JH. Unusual location for an ingested foreign body. ANZ J Surg 2020; 91:1024-1026. [PMID: 32996686 DOI: 10.1111/ans.16317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 09/04/2020] [Indexed: 11/29/2022]
Affiliation(s)
| | - Tousif Kabir
- Department of General Surgery, Sengkang General Hospital, Singapore
| | - Juinn Huar Kam
- Department of General Surgery, Sengkang General Hospital, Singapore
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11
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Raut AA, Naphade PS, Maheshwari S. Abdominal Radiograph. JOURNAL OF GASTROINTESTINAL AND ABDOMINAL RADIOLOGY 2020. [DOI: 10.1055/s-0040-1701327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
AbstractAbdominal radiograph (AR) is often the initial radiological investigation performed while investigating abdominal pain even today. However, in the era of cross-sectional imaging, the role of AR in the diagnosis of acute pain abdomen is being questioned. When AR is used as a screening modality, the diagnostic yield is low. When performed in suspected cases of bowel obstruction or perforation, urinary calculi, or bowel ischemia, AR is often helpful. AR is often the first radiological investigation performed in acute abdomen. Although the role of plain radiograph is limited in the era of cross-sectional imaging, systemic approach and vigilant search for the radiological features on AR may be diagnostic and decide further line of investigation. Various gas patterns of intraluminal and free peritoneal air are helpful in localizing pathology. Different patterns of calcification seen in abdomen, ingested or inserted foreign bodies, and location of medical devices give a clue to diagnosis.
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Affiliation(s)
- Abhijit A. Raut
- Department of Radiology, Kokilaben Dhirubhai Ambani Hospital, Mumbai, Maharashtra, India
| | | | - Sharad Maheshwari
- Department of Radiology, Kokilaben Dhirubhai Ambani Hospital, Mumbai, Maharashtra, India
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12
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Management of Ingested Lead Pellets With Elevated Blood Lead Levels in a Pediatric Patient. J Pediatr Gastroenterol Nutr 2019; 69:e159-e160. [PMID: 31436710 DOI: 10.1097/mpg.0000000000002438] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
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13
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Brown J, Kidder M, Fabbrini A, deVries J, Robertson J, Chandler N, Wilsey M. Down the Rabbit Hole-Considerations for Ingested Foreign Bodies. Pediatr Gastroenterol Hepatol Nutr 2019; 22:619-623. [PMID: 31777731 PMCID: PMC6856502 DOI: 10.5223/pghn.2019.22.6.619] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 08/31/2019] [Indexed: 01/08/2023] Open
Abstract
We report the case of a seven-year-old boy with an ingested foreign body, which was retained within the appendix for a known duration of ten months, ultimately requiring appendectomy. The ingested foreign body was incidentally discovered by abdominal x-ray at an emergency room visit for constipation. Despite four bowel cleanouts, subsequent x-rays showed persistence of the foreign body in the right lower quadrant. While the patient did not have signs or symptoms of acute appendicitis, laparoscopic appendectomy was performed due to the risk of this foreign body causing appendicitis in the future. A small metallic object was found within the appendix upon removal. This case highlights the unique challenge presented by foreign body ingestions in non-verbal or developmentally challenged children and the importance of further diagnostic workup when concerns arise for potential retained foreign bodies.
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Affiliation(s)
| | - Molly Kidder
- Department of Pediatrics, University of South Florida College of Medicine, Tampa, FL, USA
| | | | | | - Jason Robertson
- Department of Pediatric Surgery, Johns Hopkins All Children's Hospital, St. Petersburg, FL, USA
| | - Nicole Chandler
- Department of Pediatric Surgery, Johns Hopkins All Children's Hospital, St. Petersburg, FL, USA
| | - Michael Wilsey
- Department of Pediatric Gastroenterology and Nutrition, Johns Hopkins All Children's Hospital, St. Petersburg, FL, USA
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Packard E, Groff A, Shahid Z, Sahu N, Jain R. A 'Bit' of Appendicitis: A Case of a Foreign Object in the Adult Appendix. Cureus 2019; 11:e4751. [PMID: 31363433 PMCID: PMC6663284 DOI: 10.7759/cureus.4751] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Accepted: 05/24/2019] [Indexed: 02/07/2023] Open
Abstract
Appendicitis is the most common abdominal surgical emergency, and if left untreated, can lead to an abscess, peritonitis, or even death. The exact mechanism of appendicitis has yet to be elucidated, but the predominant theory is that different forms of luminal obstruction of the vermiform appendix lead to ischemia of the appendix wall and subsequent translocation of bacteria across the compromised mucosa, leading to transmural inflammation. The most common etiology is hyperplasia of lymphoid tissue in the mucosa, often secondary to infection and inflammation with gradual symptom onset. Rarer causes of obstruction include parasitic infiltration, fibrous bands, carcinoid syndrome, and foreign body ingestion and often have atypical or absent symptomatology, making diagnosis more challenging and complications more frequent. We present a rare case of foreign body-associated appendicitis with distal lodging in the appendix and highlight the importance of prophylactic appendectomy to avoid severe complications.
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Affiliation(s)
- Elizabeth Packard
- Internal Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, USA
| | - Andrew Groff
- Internal Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, USA
| | - Zainab Shahid
- Internal Medicine, Lake Erie College of Osteopathic Medicine, Erie, USA
| | - Nitasa Sahu
- Internal Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, USA
| | - Rohit Jain
- Internal Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, USA
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Jiménez HC, Martínez-Montalvo CM, Maduro DA, González JC, Suaza C. "Apendicitis aguda perforada secundaria a cuerpo
extraño: reporte de caso". REVISTA COLOMBIANA DE CIRUGÍA 2019. [DOI: 10.30944/20117582.115] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
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16
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Tsukamoto R, Miyano S, Machida M, Kitabatake T, Fujisawa M, Kojima K. Appendiceal Perforation due to Migration of a Dental Instrument. Case Rep Gastroenterol 2018; 12:551-555. [PMID: 31244589 PMCID: PMC6587194 DOI: 10.1159/000444520] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 02/04/2016] [Indexed: 12/11/2022] Open
Abstract
A 40-year-old male without any past medical history accidentally swallowed a titanium dental instrument (reamer) for root canal treatment. A cathartic was prescribed at a local hospital, and the course was observed. However, since the reamer was not excreted in feces, he was referred to our hospital. After admission, CT, lower gastrointestinal endoscopy, and barium enema revealed the migration of a foreign body into the appendix and its protrusion into the intraperitoneal cavity. As an emergency operation, laparoscopic appendectomy including the foreign body was performed. The following course was favorable without postoperative complications, and he was discharged on the 2nd hospital day. We report a patient with appendiceal perforation due to a foreign body (dental instrument for root canal treatment) in the appendix.
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Affiliation(s)
- Ryoichi Tsukamoto
- Department of General Surgery, Juntendo Nerima Hospital, Tokyo, Japan
| | - Shozo Miyano
- Department of General Surgery, Juntendo Nerima Hospital, Tokyo, Japan
| | - Michio Machida
- Department of General Surgery, Juntendo Nerima Hospital, Tokyo, Japan
| | | | - Minoru Fujisawa
- Department of General Surgery, Juntendo Nerima Hospital, Tokyo, Japan
| | - Kuniaki Kojima
- Department of General Surgery, Juntendo Nerima Hospital, Tokyo, Japan
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Ingested razor blades within the appendix: A rare case report. Int J Surg Case Rep 2018; 45:29-32. [PMID: 29571061 PMCID: PMC6000989 DOI: 10.1016/j.ijscr.2018.03.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 03/05/2018] [Indexed: 11/21/2022] Open
Abstract
INTRODUCTION Foreign body ingestion is a common clinical presentation with less than 1% of the cases requiring surgical intervention. In this report, we present a rare case of razor blades lodged in the appendix as a result of intentional ingestion. PRESENTATION OF CASE A 25 year old male prisoner presented to our hospital with persistent right iliac fossa pain after razor blade ingestion. After 5 days of conservative management, there was no sign of transition on serial X-Rays. Laparoscopy with intraoperative image intensification confirmed the presence of the razor blades in the appendix and appendicectomy was subsequently performed without complications. DISCUSSION Most ingested objected with diameter less than 2.5 cm and length less than 6 cm can pass through the gastrointestinal tract spontaneously in less than one week. The entry of foreign objects into the appendix is thought to be due to relative low motility of the caecum, the dependent position of the appendix and the size of the appendiceal orifice. Radiographic localisation to the appendiceal lumen was complicated by metallic artefact, but was consistent with failure to transit. Appendicectomy was felt to be the safest mode of retrieval. CONCLUSION Ingested foreign body lodged in the appendix is a rare event. Once the exact location is confirmed, a simple laparoscopic appendicectomy can be performed to facilitate the removal.
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Zubair ON, Carroll D, Goodall K. Concurrent partial small bowel obstruction and acute appendicitis secondary to play-dough ingestion. JOURNAL OF PEDIATRIC SURGERY CASE REPORTS 2018. [DOI: 10.1016/j.epsc.2017.09.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Campora M, Trambaiolo Antonelli C, Grillo F, Bragoni A, Cornara L, Migliora P, Pigozzi S, Mastracci L. Seeds in the appendix: a ‘fruitful’ exploration. Histopathology 2017; 71:322-325. [PMID: 28295494 DOI: 10.1111/his.13211] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Michela Campora
- Pathology Unit, Department of Surgical and Diagnostic Sciences (DISC); University of Genoa; Genoa Italy
| | | | - Federica Grillo
- Pathology Unit, Department of Surgical and Diagnostic Sciences (DISC); University of Genoa; Genoa Italy
- IRCCS AOU S. Martino-IST; Genoa Italy
| | - Alberto Bragoni
- Pathology Unit, Department of Surgical and Diagnostic Sciences (DISC); University of Genoa; Genoa Italy
| | - Laura Cornara
- Department for the Earth, Environment and Life Sciences (DiSTAV); University of Genoa; Genoa Italy
| | | | - Simona Pigozzi
- Pathology Unit, Department of Surgical and Diagnostic Sciences (DISC); University of Genoa; Genoa Italy
- IRCCS AOU S. Martino-IST; Genoa Italy
| | - Luca Mastracci
- Pathology Unit, Department of Surgical and Diagnostic Sciences (DISC); University of Genoa; Genoa Italy
- IRCCS AOU S. Martino-IST; Genoa Italy
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Sama CB, Aminde LN, Njim TN, Angwafo FF. Foreign body in the appendix presenting as acute appendicitis: a case report. J Med Case Rep 2016; 10:129. [PMID: 27225444 PMCID: PMC4881009 DOI: 10.1186/s13256-016-0922-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Accepted: 04/29/2016] [Indexed: 12/29/2022] Open
Abstract
Background Foreign bodies are a rare cause of appendicitis. In most instances, ingested foreign bodies pass through the alimentary tract asymptomatically. However, those that enter the lumen of the vermiform appendix may not be able to re-enter the colon and may initiate an inflammatory process. We report a case of acute appendicitis induced by an unusual foreign body. Case presentation A 26-year-old Sub-Saharan woman presented with right iliac fossa pain and tenderness. She underwent an open appendectomy which revealed a condom fragment within the appendiceal lumen. A detailed retrospective history confirmed accidental ingestion of the condom 2 weeks prior to onset of symptoms. Conclusions Although a rare finding, a variety of foreign bodies can be lodged in the appendix and may instigate an inflammatory process. There is a need to increase awareness of the potential dangers of ingested foreign bodies.
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Affiliation(s)
- Carlson B Sama
- Islamic Medicalized Health Centre-Babessi and Department of Surgery, Faculty of Health Sciences, University of Buea, Buea, Cameroon. .,Galactic Corps Research Group (GCRG), Buea, Cameroon.
| | - Leopold N Aminde
- Clinical Research Education, Networking & Consultancy, Douala, Cameroon and, The University of Queensland, School of Public Health, Brisbane, QLD, 4006, Australia
| | - Tsi N Njim
- Bamenda Regional Hospital and Health and Human Development (2HD) Research Group, Douala, Cameroon
| | - Fru F Angwafo
- Department of Surgery, University Teaching Hospital Yaoundé and Gynaeco-Obstetric and Paediatric Hospital, Yaoundé, Cameroon
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Chou ASB, Hsu YH, Wu BG. Appendicular foreign body presenting with appendicular mass. Tzu Chi Med J 2016; 28:136-137. [PMID: 28757743 PMCID: PMC5442914 DOI: 10.1016/j.tcmj.2016.03.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2016] [Revised: 01/28/2016] [Accepted: 02/23/2016] [Indexed: 10/29/2022] Open
Affiliation(s)
- Andy Shau-Bin Chou
- Department of Medical Imaging, Buddhist Tzu Chi General Hospital, Hualien, Taiwan.,School of Medicine, Tzu Chi University, Hualien, Taiwan.,Department of Medical Imaging and Radiologic Sciences, Tzu Chi University of Science and Technology, Hualien, Taiwan
| | - Yung-Hsiang Hsu
- School of Medicine, Tzu Chi University, Hualien, Taiwan.,Department of Pathology, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
| | - Bor-Gang Wu
- School of Medicine, Tzu Chi University, Hualien, Taiwan.,Department of Surgery, Buddhist Tzu Chi General Hospital, Hualien, Taiwan
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22
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Hines JJ, Paek GK, Lee P, Wu L, Katz DS. Beyond appendicitis; radiologic review of unusual and rare pathology of the appendix. Abdom Radiol (NY) 2016; 41:568-81. [PMID: 27039327 DOI: 10.1007/s00261-015-0600-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Appendicitis is a very common cause of acute abdominal pathology, however, many other pathologic conditions of the appendix can be diagnosed utilizing CT. Examples of these conditions include primary appendiceal neoplasms, secondary inflammation of the appendix, stump appendicitis, endometriosis, appendicitis within a hernia, appendiceal diverticulosis and intussusception and intraluminal foreign bodies. The purpose of this article is to review appendiceal pathology outside of acute appendicitis, describe corresponding imaging findings on CT, and to illustrate various CT findings of appendiceal disease with representative cases.
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Affiliation(s)
- John J Hines
- Department of Radiology, North Shore-LIJ Health System, 270-05 76th Ave, New Hyde Park, NY, 11040, USA.
| | - Gina K Paek
- Department of Radiology, North Shore-LIJ Health System, 270-05 76th Ave, New Hyde Park, NY, 11040, USA
| | - Peter Lee
- Department of Radiology, North Shore-LIJ Health System, 270-05 76th Ave, New Hyde Park, NY, 11040, USA
| | - Loraine Wu
- Mid-Atlantic Permanente Medical Group, 2101 East Jefferson Street, Rockville, MD, 20852, USA
| | - Douglas S Katz
- Department of Radiology, Winthrop University Hospital, 259 First Street, Mineola, NY, 11501, USA
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23
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Bababekov YJ, Stanelle EJ, Abujudeh HH, Kaafarani HMA. Fishbone-induced perforated appendicitis. BMJ Case Rep 2015; 2015:bcr-2015-209562. [PMID: 25994432 DOI: 10.1136/bcr-2015-209562] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
We review the literature and describe a case of fishbone-induced appendicitis. A 63-year-old man presented with abdominal pain. Work up including a focused history and imaging revealed fishbone-induced perforated appendicitis. The patient was managed safely and successfully with laparoscopic removal of the foreign body and appendectomy.
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Affiliation(s)
- Yanik J Bababekov
- Department of Surgery, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, USA
| | - Eric J Stanelle
- Department of Surgery, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, USA
| | - Hani H Abujudeh
- Department of Radiology, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, USA
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24
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Engin O, Yildirim M, Yakan S, Coskun GA. Can fruit seeds and undigested plant residuals cause acute appendicitis. Asian Pac J Trop Biomed 2014; 1:99-101. [PMID: 23569736 DOI: 10.1016/s2221-1691(11)60004-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2011] [Revised: 02/27/2011] [Accepted: 03/15/2011] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To investigate the relation between fruit seeds, plants residuals and appendicitis. METHODS Among cases that underwent appendectomy, the appendicitis cases having fruit seeds and undigested plant residuals in their etiology were examined retrospectively. Also, histopathological features, age, sex, and parameters of morbidity and mortality were used. RESULTS Fruit seed was found in one case (0.05%) with presence of pus in appendix lumen, undigested plant residuals in 7 cases (0.35%). It was determined that there were appendix inflammation in 2 of the plant residuals cases, while there were obstruction and lymphoid hyperplasia in the appendix lumen of 5 cases. No mortality was observed. CONCLUSIONS The ratio of acute appendicitis caused by plants is minimal among all appendectomised patients, but avoidence of eating undigested fruit seeds and chewing plants well may help to prevent appendicitis.
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Affiliation(s)
- Omer Engin
- Izmir Bozyaka Training and Research Hospital, Surgery Departmant, Izmir-Turkey
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25
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Abstract
Most ingested foreign bodies pass through the gastrointestinal tract without any incident. However, foreign bodies lodged in the appendix can cause an inflammatory reaction with or without perforation. Here, we present a case of a 54-year-old woman with perforated appendicitis who consumed wild game containing a shot pellet. Five months before admission, she had eaten the meat of a pheasant that had been shot with a shotgun. Abdominal computed tomography confirmed the diagnosis of perforated appendicitis with abscess due to a foreign body. Subsequently, a laparoscopic appendectomy was performed. Follow-up radiographs obtained after the surgery did not identify the foreign body. Histolopathologic examination confirmed appendiceal perforation with focal inflammation secondary to a foreign body.
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26
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Sarkar RR, Bisht J, Sinha Roy SK. Ingested metallic foreign body lodged in the appendix. J Indian Assoc Pediatr Surg 2011; 16:29-30. [PMID: 21430847 PMCID: PMC3047773 DOI: 10.4103/0971-9261.74520] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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.
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Affiliation(s)
- R R Sarkar
- Department of Pediatric Surgery, Institute of Post-Graduate Medical Education and Research and Seth Sukhlal Karnani Memorial Hospital, Kolkata, India
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27
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Fields RC, DeMatteo RP. Incidentally Discovered, Intra-abdominal Metallic Foreign Object on Preoperative Imaging. Am Surg 2010. [DOI: 10.1177/000313481007600915] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Ryan C. Fields
- Department of Surgery Memorial Sloan-Kettering Cancer Center New York, New York
| | - Ronald P. DeMatteo
- Department of Surgery Memorial Sloan-Kettering Cancer Center New York, New York
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28
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Kumar R, Bawa M, Ragavan M. Ingested metallic screw causing appendicitis in an infant--the metallic 'Screw Appendicitis'. Indian J Pediatr 2010; 77:337. [PMID: 20091376 DOI: 10.1007/s12098-009-0295-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
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30
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Acute contact appendicitis due to a migrated pericardial drain: a case report. CASES JOURNAL 2009; 2:6250. [PMID: 19829774 PMCID: PMC2740180 DOI: 10.4076/1757-1626-2-6250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2009] [Accepted: 07/04/2009] [Indexed: 11/08/2022]
Abstract
INTRODUCTION The literature is replete with articles of foreign-body appendicitis and periappendicitis, but to our knowledge there are only two reports of extraintestinal foreign bodies causing contact appendicitis. CASE PRESENTATION A 47-year old woman presented to the emergency department with a 24-hour history of right iliac fossa pain, nausea and vomiting, high fever and palpable right iliac fossa mass. The patient had an anamnestic of systemic lupus erythematosus, that caused acute pericarditis with effusion, that was treated with pericardiotomy and a pericardial drain. The laboratory tests showed leukocytosis The plain abdomen film showed no radiologic signs corresponding to acute abdomen, while the computed tomography revealed a radio-opaque formation in the right iliac fossa, corresponding to the palpable mass. Exploratory laparotomy revealed a pericardial drain. The microbiologic analysis of the abscess revealed Salmonella. The postoperative course of the patient was uneventful. CONCLUSION Acute appendicitis due to a foreign body, without an anamnestic of either surgery or injury may cause a severe diagnostic dilemma. The computed tomography images may lead to logic riddles that have to be solved by an explorative laparotomy. Foreign bodies rarely cause acute abdomen, nevertheless the probability has to be considered when an interventional technique has been applied even if the location of the intervention is far from the abdominal cavity.
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31
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Recurrent appendicitis following successful conservative management of an appendicular mass in association with a foreign body: a case report. CASES JOURNAL 2009; 2:7776. [PMID: 19830011 PMCID: PMC2740186 DOI: 10.4076/1757-1626-2-7776] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/26/2009] [Accepted: 06/24/2009] [Indexed: 12/13/2022]
Abstract
Introduction Interval appendicectomy is not routinely indicated after successful resolution of an appendix mass. Whether this policy can also be applied to patients with appendicular foreign body presenting with an appendix mass remains a matter of debate. We report here a patient who presented with recurrent symptoms following conservative management of an appendicular mass associated with a foreign body in the appendix. We also review the available literature briefly. Case presentation A 70 year old gentleman was admitted with right iliac fossa pain, tenderness, and raised inflammatory markers. A computed tomography scan of his abdomen showed an appendix mass with a small abscess and a linear opaque foreign body. His symptoms resolved completely on conservative management with intravenous antibiotics. A colonoscopy few weeks later was unremarkable. He presented with recurrent symptoms a few months later. A repeat computed tomography scan showed persistent appendicular abscess with the same foreign body in it. A laparotomy with appendicectomy, abscess drainage and removal of the foreign body was carried out with satisfactory outcome. Conclusion Surgeons should be aware of appendicular foreign body as a cause of persistent/recurrent symptoms after conservative management of appendicular mass. These patients require prompt surgery and formal appendicectomy. Interval appendicectomy should be considered.
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32
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Hartin CW, Lau ST, Caty MG. Metallic foreign body in the appendix of 3-year-old boy. J Pediatr Surg 2008; 43:2106-8. [PMID: 18970950 DOI: 10.1016/j.jpedsurg.2008.07.026] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2008] [Revised: 07/22/2008] [Accepted: 07/23/2008] [Indexed: 12/13/2022]
Abstract
Foreign body-induced appendicitis is a rare but well-known entity. This condition was discovered during the first appendectomy performed almost 275 years ago. For the pediatric surgeon, evaluation of a patient for swallowed foreign bodies is common, and most foreign bodies traverse the gastrointestinal tract without incident. However, when the foreign body becomes incarcerated in the appendix, a prophylactic appendectomy is recommended to prevent appendicitis. We present the case of an asymptomatic 3-year-old boy with a metallic foreign body lodged in the appendix that was treated with a fluoroscopically assisted laparoscopic appendectomy and discuss treatment of sharp vs blunt foreign bodies of the appendix.
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Affiliation(s)
- Charles W Hartin
- Department of Surgery, Division of Pediatric Surgery, Women and Children's Hospital of Buffalo, State University of New York at Buffalo, Buffalo, NY 14222, USA
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33
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Tsuji LJS, Wainman BC, Martin ID, Sutherland C, Weber JP, Dumas P, Nieboer E. The identification of lead ammunition as a source of lead exposure in First Nations: the use of lead isotope ratios. THE SCIENCE OF THE TOTAL ENVIRONMENT 2008; 393:291-298. [PMID: 18272204 DOI: 10.1016/j.scitotenv.2008.01.022] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2007] [Revised: 12/29/2007] [Accepted: 01/04/2008] [Indexed: 05/25/2023]
Abstract
The use of lead shotshell to hunt water birds has been associated with lead-contamination in game meat. However, evidence illustrating that lead shotshell is a source of lead exposure in subsistence hunting groups cannot be deemed definitive. This study seeks to determine whether lead shotshell constitutes a source of lead exposure using lead isotope ratios. We examined stable lead isotope ratios for lichens, lead shotshell and bullets, and blood from residents of Fort Albany and Kashechewan First Nations, and the City of Hamilton, Ontario, Canada. Data were analyzed using ANOVA and regression analyses. ANOVA of isotope ratios for blood revealed significant differences with respect to location, but not sex. Hamilton differed from both Kashechewan and Fort Albany; however, the First Nations did not differ from each other. ANOVA of the isotope ratios for lead ammunition and lichens revealed no significant differences between lichen groups (north and south) and for the lead ammunition sources (pellets and bullets). A plot of (206)Pb/(204)Pb and (206)Pb/(207)Pb values illustrated that lichens and lead ammunition were distinct groupings and only the 95% confidence ellipse of the First Nations group overlapped that of lead ammunition. In addition, partial correlations between blood-lead levels (adjusted for age) and isotope ratios revealed significant (p<0.05) positive correlations for (206)Pb/(204)Pb and (206)Pb/(207)Pb, and a significant negative correlation for (208)Pb/(206)Pb, as predicted if leaded ammunition were the source of lead exposure. In conclusion, lead ammunition was identified as a source of lead exposure for First Nations people; however, the isotope ratios for lead shotshell pellets and bullets were indistinguishable. Thus, lead-contaminated meat from game harvested with lead bullets may also be contributing to the lead body burden.
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Affiliation(s)
- Leonard J S Tsuji
- Department of Environment and Resource Studies, University of Waterloo, Waterloo, ON, Canada.
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34
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Asad S, Bae K, Jeon KN, Cho JM, Shin TB, Joo YT, Kim HJ. Appendicitis caused by a foreign body of dental origin: diagnosis with ultrasonography. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2007; 26:967-70. [PMID: 17592060 DOI: 10.7863/jum.2007.26.7.967] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Affiliation(s)
- Sadaf Asad
- Department of Diagnostic Radiology, Gyeongsang National University College of Medicine, Gyeongsang National University Hospital, Jinju, Korea
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Abstract
Granulomatous inflammation of the appendix is uncommon. It can be caused by a variety of conditions, including systemic disorders such as Crohn's disease and sarcoidosis, and infections such as mycobacterium tuberculosis, yersinia pseudotuberculosis, parasites and fungi. Granulomatous appendicitis as an isolated pathological entity unassociated with systemic disease is rare. Isolated granulomatous inflammation of the appendix of unknown aetiology, otherwise known as idiopathic granulomatous appendicitis is extremely rare. Patients with this condition present with the typical signs and symptoms of acute appendicitis. We present a series of patients with isolated granulomatous inflammation of the appendix, and discuss the difficulties encountered in the management of this condition.
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Affiliation(s)
- O N Tucker
- Department of Surgery, The Adelaide and Meath Hospital, Tallaght, Dublin 24, Ireland
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36
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37
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Abstract
Foreign bodies are uncommon, but they are important and interesting. Foreign bodies may be ingested, inserted into a body cavity, or deposited into the body by a traumatic or iatrogenic injury. Most ingested foreign bodies pass through the gastrointestinal tract without a problem. Most foreign bodies inserted into a body cavity cause only minor mucosal injury. However, ingested or inserted foreign bodies may cause bowel obstruction or perforation; lead to severe hemorrhage, abscess formation, or septicemia; or undergo distant embolization. Motor vehicle accidents and bullet wounds are common causes of traumatic foreign bodies. Metallic objects, except aluminum, are opaque, and most animal bones and all glass foreign bodies are opaque on radiographs. Most plastic and wooden foreign bodies (cactus thorns, splinters) and most fish bones are not opaque on radiographs. All patients should be thoroughly screened for foreign bodies before undergoing a magnetic resonance imaging study.
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Affiliation(s)
- Tim B Hunter
- Department of Radiology, University of Arizona Health Sciences Center, 1501 N Campbell Ave, Tucson, AZ 85724, USA.
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38
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Lheureux P, Cavenaile JC, Cornil A, Nouvelle M, Sermon F, Leduc D, Askenasi R. Ingestion de corps étrangers : attitude pratique. ACTA ACUST UNITED AC 1996. [DOI: 10.1016/s1164-6756(05)80578-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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39
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Abstract
The authors report the case of a 9-year-old boy who had a needle in his appendix. The contrast between absence of clinical symptoms and clear inflammatory changes of the appendix is noted. The authors recommend appendectomy for patients with pointed foreign bodies in the appendix to avoid inflammation and perforation.
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Affiliation(s)
- I Sukhotnik
- Department of Pediatric Surgery, Central Emek Hospital, Afula, Israel
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40
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Abstract
An unusual case of acute appendicitis induced by a metal drill bit that was ingested by a 27-year-old man 3 years before presentation is reported. This foreign body lodged in the patient's appendix and developed a fecalith coating. When this fecalith coating enlarged enough to obstruct the appendiceal lumen, the patient presented with classic acute appendicitis. Foreign body-induced appendicitis is reviewed.
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Affiliation(s)
- S M Green
- Department of Emergency Medicine, Riverside General Hospital, CA 92503
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41
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42
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Shafer N, Kitay G. Acute appendicitis associated with diesel fuel. Gastroenterology 1987; 93:1146-7. [PMID: 3653638 DOI: 10.1016/0016-5085(87)90600-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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43
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Stretch J, Bilous M, Cass D. Tricholuminal appendicitis: an unusual cause. THE AUSTRALIAN AND NEW ZEALAND JOURNAL OF SURGERY 1986; 56:731-2. [PMID: 3467705 DOI: 10.1111/j.1445-2197.1986.tb02382.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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44
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Abstract
Over a 20 year period 26 patients were admitted because of ingesting foreign bodies. Ten patients, mostly children, remembered swallowing a metallic foreign body. Most of the patients were asymptomatic and were admitted for observation. Sixteen patients underwent operation. The distal large bowel was the area most commonly involved, not the ileocecal region as in the reviews published a number of years ago. Blunt as well as pointed foreign bodies caused bowel perforations, probably through slow pressure necrosis. Most of the patients had signs of localized peritonitis.. Unlike previous studies, roentgenographic studies were found helpful in the preoperative diagnosis.
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Abstract
Seventy pediatric patients with histories of recurrent crampy abdominal pain, right lower quadrant tenderness, and proven filling defects or distention of the appendix on radiographs, have been subjected to appendectomy. Inspissated fecal material was found within the appendix in 72.8% of such children. Fecal material was found in only 12.9% of 155 normal appendices and in 33.8% of 530 acutely inflamed appendices. It is postulated that inspissated fecal material acts as a foreign body of the appendix, leading to intermittent obstruction and distention of the appendix--appendiceal colic. An 86% correlation between the appendiceal filling defects seen on radiographs and the inspissated fecal material found within the appendix at operation has been noted. Ninety-six per cent of these 70 children had been relieved of their recurrent abdominal pain by appendectomy. Appendiceal colic characterized by crampy abdominal pain, right lower quadrant tenderness, and appendiceal filling defects appears to be a veritable and verifiable diagnosis.
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46
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Bissada NK, Finkbeiner AE, Rountree GA, Redman JF. Foreign bodies in the spermatic cord. J Urol 1977; 118:1010-1. [PMID: 926238 DOI: 10.1016/s0022-5347(17)58279-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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47
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Simstein NL, Mattox KL. Penetrating injuries of the appendix. Am J Surg 1977; 134:415. [PMID: 900347 DOI: 10.1016/0002-9610(77)90419-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Although rare, penetrating injuries of the appendix pose an interesting finding at laparotomy. Associated penetrating gastrointestinal injuries are common. Four additional cases of trauma to the appendix from penetrating wounds are described.
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48
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Kassner EG, Mutchler RW, Klotz DH, Rose JS. Uncomplicated foreign bodies of the appendix in children: radiologic observations. J Pediatr Surg 1974; 9:207-11. [PMID: 4825793 DOI: 10.1016/s0022-3468(74)80123-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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