1
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
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
| |
Collapse
|
2
|
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] [What about the content of this article? (0)] [Affiliation(s)] [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.
Collapse
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
| |
Collapse
|
3
|
Asaad HR, Faraj HI, Altom A, Ahmed SA, Muhammad BK, Rashid MJ, Aziz JMA, Khdhir RH, Huy NT. Abdominal pain from ingested bone misdiagnosed as appendicitis: Report of a rare case and literature review. Radiol Case Rep 2022; 17:4111-4114. [PMID: 36065240 PMCID: PMC9439961 DOI: 10.1016/j.radcr.2022.07.108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 07/26/2022] [Accepted: 07/31/2022] [Indexed: 11/17/2022] Open
Abstract
Bones are potential foreign bodies that could be accidentally ingested, leading to several symptoms varying from asymptomatic to perforation of the gastrointestinal tract. However, these cases are rare but may be misdiagnosed with other common diseases such as appendicitis. We present in this case a 25-year-old male who presented with appendicitis symptoms, after appendectomy the patient had the same complaint, But the colonoscopy demonstrated a meat bone in the terminal ileum and was removed with the same device. Finally, he was discharged from the hospital without complications and after decreasing abdominal pain. According to the literature review, this is one of the rare cases of using colonoscopy to treat bone impaction non-operatively.
Collapse
Affiliation(s)
- Hoshman Rahman Asaad
- Baxshin Research Center, Baxshin Hospital, Sulaimani, Kurdistan Region, Iraq
- Kurdistan Center for Gastroenterology and Hepatology, Sulaimani, Kurdistan, Iraq
| | - Heero Ismael Faraj
- Kurdistan Center for Gastroenterology and Hepatology, Sulaimani, Kurdistan, Iraq
| | - Ahmed Altom
- Department of Internal Medicine, Faculty of Medicine, Damascus University, Damascus, Syrian Arab Republic
| | | | - Bakhtyar Kamal Muhammad
- Baxshin Research Center, Baxshin Hospital, Sulaimani, Kurdistan Region, Iraq
- Anesthesia Department Technical, College of Health, Sulaimani, Polytechnic University, Kurdistan Region, Iraq
| | | | - Jeza M. Abdul Aziz
- Baxshin Research Center, Baxshin Hospital, Sulaimani, Kurdistan Region, Iraq
- Medical laboratory science, College of health sciences, University of Human Development, Sulaimani, Kurdistan Region, Iraq
- Corresponding authors.
| | | | - Nguyen Tien Huy
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, 852-8523, Japan
- Corresponding authors.
| |
Collapse
|
4
|
Espin DS, Tufiño JF, Cevallos JM, Zumárraga F, Orozco VE, Proaño EJ, Molina GA. A needle in the colon, the risk of ingested foreign objects: a case report. J Surg Case Rep 2021; 2021:rjab455. [PMID: 34703574 PMCID: PMC8542396 DOI: 10.1093/jscr/rjab455] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2021] [Accepted: 09/20/2021] [Indexed: 12/30/2022] Open
Abstract
Ingestion of foreign bodies is often found in clinical practice; however, intestinal perforation due to ingestion of foreign bodies is rare. Sharp and metallic objects are usually the ones that cause most complications. Preoperative diagnosis is difficult since the clinical presentation is vague and nonspecific presentation can simulate many abdominal pathologies. Patients are rarely aware of foreign body ingestion, and a high index of suspicion is required to make a timely diagnosis. In addition, treatment demands prompt surgery to avoid dangerous complications. We present the case of a 19-year-old tailor; he inadvertently swallowed a needle and presented to the emergency department with a colonic perforation. Surgery was required, and he recovered completely.
Collapse
Affiliation(s)
- Darwin S Espin
- Department of General Surgery, Hospital San Francisco, IESS, Quito, Ecuador
| | - Jorge F Tufiño
- Department of General Surgery, Hospital San Francisco, IESS, Quito, Ecuador
| | - Jaime M Cevallos
- Department of General Surgery, Hospital San Francisco, IESS, Quito, Ecuador
| | | | - Vanessa E Orozco
- PGY3 Pontificia Universidad Catolica del Ecuador, Quito, Ecuador
| | | | - Gabriel A Molina
- Department of General Surgery at Hospital Metropolitano & Universidad San Francisco (USFQ), Quito, Ecuador
| |
Collapse
|
5
|
Kuwahara K, Mokuno Y, Matsubara H, Kaneko H, Shamoto M, Iyomasa S. Development of an abdominal wall abscess caused by fish bone ingestion: a case report. J Med Case Rep 2019; 13:369. [PMID: 31837708 PMCID: PMC6911699 DOI: 10.1186/s13256-019-2301-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2019] [Accepted: 10/18/2019] [Indexed: 12/15/2022] Open
Abstract
Background A small percentage of patients with foreign body ingestion develop complications, which have a variety of clinical presentations. Less than 1% of cases require surgical intervention. We present a patient with an abdominal wall abscess resulting from a fish bone that pierced the cecum. The patient was treated laparoscopically. Case presentation A 55-year-old Japanese man presented to our hospital with a complaint of right lower abdominal pain. A physical examination revealed tenderness, swelling, and redness at the right iliac fossa. Computed tomography showed a low-density area with rim enhancement in his right internal oblique muscle and a hyperdense 20 mm-long pointed object in the wall of the adjacent cecum. Based on the findings we suspected an abdominal wall abscess resulting from a migrating ingested fish bone. He was administered antibiotics as conservative treatment, and the abscess was not seen on subsequent computed tomography. Two months after the initial treatment, he presented with the same symptoms, and a computed tomography scan showed the foreign body in the same location as before with the same low-density area. We diagnosed the low-density area as recurrence of the abdominal wall abscess. He underwent laparoscopic surgery to remove the foreign body. His appendix, and part of his cecum and the parietal peritoneum that included the foreign body, were resected. He had an uneventful postoperative course, and at 1 year after the surgery, the abdominal wall abscess had not recurred. Conclusions An abdominal wall abscess developed in association with the migration of an ingested fish bone. We suggest that a laparoscopic surgical resection of the portion of the bowel that includes the foreign body is a useful option for selected cases.
Collapse
Affiliation(s)
- Kiyomitsu Kuwahara
- Department of Surgery, Yachiyo Hospital, 2-2-7, Sumiyoshi-cho, Anjo-shi, Aichi, 446-8510, Japan.
| | - Yasuji Mokuno
- Department of Surgery, Yachiyo Hospital, 2-2-7, Sumiyoshi-cho, Anjo-shi, Aichi, 446-8510, Japan
| | - Hideo Matsubara
- Department of Surgery, Yachiyo Hospital, 2-2-7, Sumiyoshi-cho, Anjo-shi, Aichi, 446-8510, Japan
| | - Hirokazu Kaneko
- Department of Surgery, Yachiyo Hospital, 2-2-7, Sumiyoshi-cho, Anjo-shi, Aichi, 446-8510, Japan
| | - Mikihiro Shamoto
- Department of Pathology, Yachiyo Hospital, 2-2-7, Sumiyoshi-cho, Anjo-shi, Aichi, 446-8510, Japan
| | - Shinsuke Iyomasa
- Department of Surgery, Yachiyo Hospital, 2-2-7, Sumiyoshi-cho, Anjo-shi, Aichi, 446-8510, Japan
| |
Collapse
|