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Cuervo-Ollervides LF, Serafio-Gómez JL, Jauregui-Salazar IA, Cervantes-Sánchez CR. Foreign Body Ingestion by a Psychiatric Patient Requiring an Appendectomy: A Case Report. Cureus 2023; 15:e46977. [PMID: 38021624 PMCID: PMC10640875 DOI: 10.7759/cureus.46977] [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: 10/13/2023] [Indexed: 12/01/2023] Open
Abstract
In the surgical field, the correct approach to the psychiatric patient represents a medical challenge, given the special considerations to be taken in the individualization of their diagnosis and treatment. We present an uncommon case of a 29-year-old patient with associated psychiatric pathology who presented to the emergency room after the introduction of two foreign bodies into the nasal cavity. After the endoscopic removal of one of the foreign bodies, the X-ray follow-up shows a second foreign body into the esophagus, which progressed to the vermiform appendix, causing the classical clinical signs of acute appendicitis as a complication. The importance of considering that events treated by the otorhinolaryngology area may have complications for urgent management by the general surgery service is denoted in this article.
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Affiliation(s)
| | - José L Serafio-Gómez
- General Surgery, Chihuahua City General Hospital "Dr. Salvador Zubirán Anchondo", Chihuahua, MEX
| | | | - Carlos R Cervantes-Sánchez
- Educational Research Department, Faculty of Medicine and Biomedical Sciences, Autonomous University of Chihuahua, Chihuahua, MEX
- General Surgery, Chihuahua City General Hospital "Dr. Salvador Zubirán Anchondo", Chihuahua, MEX
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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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Hamadneh M, Al-Khalaileh M, Alayed A, Barhoush FR, Hijazin S, Haddad J, Abu-Jeyyab M. Previous Foreign Body Ingestion in the Appendix Causing Acute Appendicitis: A Case Report. Cureus 2023; 15:e34948. [PMID: 36938180 PMCID: PMC10017911 DOI: 10.7759/cureus.34948] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/13/2023] [Indexed: 02/16/2023] Open
Abstract
Acute appendicitis due to a foreign body is a very rare condition with an incidence of 0.0005% of all appendicitis cases and among all age groups. It is one of the atypical cases of appendicitis, and it is a rare condition commonly asymptomatic; there is a period of time between ingestion of the body and appendicitis. A 14-year-old female patient presented to the emergency room with right lower quadrant colicky pain. Moreover, it was progressive with six hours duration, preceded by loss of appetite. It was associated with nausea, non-projectile vomiting, and diarrhea. By taking the past medical history, the patient had a history of multiple times of foreign ingestions when she was younger. On examination, the patient appeared ill, and was vitally stable. On palpation, the patient had a right lower quadrant tenderness. The patient had positive pointing, rebound, Rovsing, and psoas signs. Full labs were done. Abdominal x-ray revealed a radiopaque metallic body in the right lower quadrant. By ultrasound, there was a minimal free fluid collection in the pelvis. Intraoperatively, the appendix looked hyperemic. Appendectomy was performed, and a needle was extracted from the appendix. Furthermore, the histopathology revealed an early inflamed appendix. Foreign body-causing appendicitis is a rare condition. We need to investigate suspected cases carefully because the presentation is atypical, and sometimes the patients are asymptomatic.
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Affiliation(s)
| | | | - Aseed Alayed
- School of Medicine, Mutah University, Al-Karak, JOR
- General Member, Mutah Research and Audit Society, Amman, JOR
| | - Farah R Barhoush
- Emergency Medicine, King Abdullah University Hospital (KAUH), Irbid, JOR
| | - Sereena Hijazin
- School of Medicine, Mutah University, Al-Karak, JOR
- General Member, Mutah Research and Audit Society, Amman, JOR
| | - Jorgeat Haddad
- School of Medicine, Mutah University, Al-Karak, JOR
- General Member, Mutah Research and Audit Society, Amman, JOR
| | - Mohammad Abu-Jeyyab
- School of Medicine, Mutah University, Al-Karak, JOR
- Coordinator, Mutah Research and Audit Society, Amman, JOR
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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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Fields J, Quinn K, Hollinger L, Jones R. Case report: Amyand hernia reincarnate and the utility of computed tomography. ANNALS OF PEDIATRIC SURGERY 2020. [DOI: 10.1186/s43159-020-00042-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
Abstract
Background
An Amyand hernia is a rare condition in which the vermiform appendix follows the bowel as it bulges through the inguinal canal. Originally described by Claudius Amyand in 1735 in an 11-year-old boy who had a pin in the appendix (Philos Trans R Soc Lond. 1735;39:329–36), we describe here the first case with CT depicting all components of Dr. Amyand’s original case.
Case presentation
A 10-year-old boy presented with right lower quadrant and groin pain. CT imaging revealed a retained metallic foreign body perforating the appendix, acute appendicitis, and an Amyand hernia. A laparoscopic attempt at reduction failed due to tethering by the needle and inflammation of the hernia sac, requiring an open inguinal exploration and excision of the hernia sac. The patient was discharged on postoperative day 2 with plans for delayed hernia repair.
Conclusions
CT is a crucial diagnostic test for surgical decision-making in Amyand hernias. In this case, it accurately classified the hernia and led to anticipation of unsuccessful laparoscopic hernia reduction. Management in the setting of foreign body and perforation includes appendectomy and tissue herniorrhaphy with delayed formal inguinal hernia repair after inflammation has subsided.
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Tustumi F, Hudari GG, Modolo NR, Morrell ALG, de Miranda Neto AA, Dias AR. Unusual cause of appendicitis. A case report of acute appendicitis caused by needle ingestion. Int J Surg Case Rep 2020; 72:499-502. [PMID: 32698274 PMCID: PMC7317165 DOI: 10.1016/j.ijscr.2020.05.094] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 05/29/2020] [Accepted: 05/30/2020] [Indexed: 12/29/2022] Open
Abstract
INTRODUCTION Appendicitis is an acute inflammatory process. The purpose of this report is to describe an unusual case of acute appendicitis in adult caused by accidental ingestion of a needle, and treated with appendectomy. PRESENTATION OF CASE A 64 year-old white woman, seamstress, was admitted with abdominal pain complaints. Plain radiograph and CT scan showed metal density suggesting a foreign body in the lower right abdomen. A diagnostic laparoscopic procedure identified a perforated appendicitis due to a needle perforation. Laparoscopic appendicectomy and foreign body removal were performed. DISCUSSION Acute appendicitis due foreign body ingestion is extremely rare. Laparoscopy was the chosen access once it was more suitable for inventory of the gastrointestinal tract and help avoiding harm of the medical team during hand maneuvers of open access surgery. CONCLUSION Foreign body ingestion should be remembered as an unusual differential diagnosis of acute appendicitis.
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