Ingested foreign bodies within the appendix: A 100-year review of the literature

Background/Aim: Appendicitis and its complications remain a common problem affecting patients of all age groups. Foreign bodies are a rare cause of ap pendicitis. We tried to define potentially dangerous foreign bodies that ma y cause appendicitis and summarize general guidelines for their clinical ma nagement. Methods: A 100-year literature review including 256 cases of inge sted foreign bodies within the appendix with emphasis on: (I) objects that are more prone to cause appendicitis or appendiceal perforation; (2) foreig n bodies that are radiopaque and may be detected during follow-up with plai n abdominal films, and (3) guidelines for clinical management.. Results: Co mplications usually occur with sharp, thin, stiff, pointed and long objects . The majority of these objects are radiopaque. An immediate attempt should be made to remove a risky object by gastroscopy. If this fails, clinical f ollow-up with serial abdominal radiographs should be obtained, If the anato mical position of the object appears not to change and, most commonly, rema ins in the right lower abdominal quadrant, an attempt at colonoscopic remov al is indicated. If this is unsuccessful, laparoscopic exploration with flu oroscopic guidance should be carried out to localize and remove the objects either by ileotomy, colotomy, or by appendectomy, Conclusion: Foreign bodi es causing appendicitis are rare. However, if stiff or pointed objects get into the appendiceal lumen they have a high risk for appendicitis or perfor ation. These foreign bodies are almost always radiopaque.