Geisinger Commonwealth School of Medicine Waverly, NY, United States
Marc A. Incitti, MSc, RN1, Ammara Khalid, MD2, Yakub I. Khan, MD3 1Geisinger Commonwealth School of Medicine, Waverly, NY; 2Geisinger Medical Center, Danville, PA; 3Geisinger Medical Center, Wilkes-Barre, PA
Introduction: Swallowed foreign objects rarely convene within the vermiform appendix and are usually excreted without incidence if reaching that alimentary transit point. Typically for adult patients, food is the foreign body culprit in cases requiring gastroenterological consultation. Indeed, there are limited studies published describing removal by colonoscopy of ingested iatrogenic foreign bodies from the appendix.
Case Description/Methods: A 52-year-old male was sent to the emergency department after witnessed ingestion of a dental foreign body. Patient was noted to be asymptomatic at the time of presentation. CT scan revealed a 2.5 cm long metallic foreign body in the proximal appendix. Subsequently, a colonoscopy was performed for retrieval of foreign body. Foreign body was identified as a flame-shaped dental bur, commonly used in tooth restorations and sub-gingival curettage. This patient was prescribed a 5-day course of prophylactic antibiotics and was discharged to home.
Discussion: The cecum has a lower motility than the preceding ileum, allowing for a temporary local stasis of ingested foreign bodies. If it reaches the appendix, the chance for it to lodge within depends on the luminal diameter and its relative orientation for transit. Given the physiologically inadequate peristalsis of the appendix and the problematic shape of the dental bur, colonoscopic retrieval was necessary in this case to prevent perforation and subsequent disease to the patient. Although foreign body-induced appendicitis cases have been documented, this patient’s appendix was unremarkable and normal in caliber.
Figure: 1. CT scan showing the dental bur in the lumen of the appendix. 2. Colonoscope-retrieved ingested dental bur
Marc Incitti indicated no relevant financial relationships.
Ammara Khalid indicated no relevant financial relationships.
Yakub Khan indicated no relevant financial relationships.
Marc A. Incitti, MSc, RN1, Ammara Khalid, MD2, Yakub I. Khan, MD3. P2314 - Dental Foreign Body Found in Appendix of 52-Year-Old, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.