A ‘Bit’ of Appendicitis: A Case of a Foreign Object in the Adult Appendix

Abstract

Appendicitis is the most common abdominal surgical emergency, and if left untreated, can lead to an abscess, peritonitis, or even death. The exact mechanism of appendicitis has yet to be elucidated, but the predominant theory is that different forms of luminal obstruction of the vermiform appendix lead to ischemia of the appendix wall and subsequent translocation of bacteria across the compromised mucosa, leading to transmural inflammation. The most common etiology is hyperplasia of lymphoid tissue in the mucosa, often secondary to infection and inflammation with gradual symptom onset. Rarer causes of obstruction include parasitic infiltration, fibrous bands, carcinoid syndrome, and foreign body ingestion and often have atypical or absent symptomatology, making diagnosis more challenging and complications more frequent. We present a rare case of foreign body-associated appendicitis with distal lodging in the appendix and highlight the importance of prophylactic appendectomy to avoid severe complications.