INSTRUCTIVE CASES

Foreign Body Producing Appendicitis Lawrence Duckler, M.D.

ALTHOUGH

LTHt’~LT~H it has been well documented that foreign bodies can produce appendicitis, it is always important to be reminded of what may be regarded as common knowledge. We recently saw a ten-year-old girl who had swallowed a straight large-headed pin with no immediate untoward effects. She remained asymptomatic and was followed by the attending surgeon for several months as an outpatient. At her last visit, a flat x-ray view of the abdomen was taken. This revealed a foreign body (presumably the pin) in the right lower quadrant of the abdomen. Since she was asymptomatic, she was treated conservatively and was not examined again until approximately ten months later. At that time, she complained of pain in the area. Her abdomen was flat, soft, and nontender. No masses, liver, spleen, or kidney could be palpated. Her white blood count was 10,000. -

Department of Surgery, Bess Kaiser Hospital, Portland,

Ore. 97217.

FIG. 1.

Photograph showing the head the distal end of the excised

of the pin lying in appendix.

Her urine was normal. Another x-ray film revealed a pin in the region of the pain. An uncomplicated appendectomy was done through a McBurney’s muscle-splitting incision. The pin, which had a smooth head, had entered the appendix. The tip of the pin had perforated the mucosa and had barely perforated the serosa.

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Foreign body producing appendicitis.

INSTRUCTIVE CASES Foreign Body Producing Appendicitis Lawrence Duckler, M.D. ALTHOUGH LTHt’~LT~H it has been well documented that foreign bodies ca...
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