Appendicular foreign body: patience needed

Abstract

A 7-year-old boy was referred to the emergency room following ingestion of a metal coil. A plain abdominal radiograph demonstrated the presence of the coil in the right lower quadrant. The child had no clinical symptoms. On serial abdominal radiographs during the following four weeks, the coil had not moved. Colonoscopy and subsequent CR scan confirmed that the coil was in the appendix. Four weeks later, before surgery, the coil was not detected by another abdominal radiograph. This case suggests that in a symptomatic child who is suspected to have an appendicular foreign body, observing the patient even for two months should be attempted and may preclude surgery.