Pediatr Gastroenterol Hepatol Nutr.  2019 Nov;22(6):619-623. 10.5223/pghn.2019.22.6.619.

Down the Rabbit Hole-Considerations for Ingested Foreign Bodies

• Brown J
• Kidder M
• Fabbrini A
• deVries J
• Robertson
• Chandler N
• Wilsey M

• KMID: 2462105
• DOI: http://doi.org/10.5223/pghn.2019.22.6.619

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.

Keyword

Appendix; Foreign bodies; Pediatrics; Gastroenterology; Endoscopy; Appendicitis; Appendectomy; Autism spectrum disorder

MeSH Terms

Appendectomy
Appendicitis
Appendix
Autism Spectrum Disorder
Child
Constipation
Emergency Service, Hospital
Endoscopy
Foreign Bodies*
Gastroenterology
Humans
Male
Pediatrics

Figure

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  Fig. 1 Abdominal radiograph showing fecal retention and a 7 mm radiopaque foreign body in the right lower quadrant.

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  Fig. 2 Computed tomography scan showing a retained appendiceal foreign body on (A) coronal and (B) axial sections.

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  Fig. 3 Gross specimen with the foreign body extracted.

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