Computer tomography imaging of an unusual cause of appendicitis: a case report
Case Report

Computer tomography imaging of an unusual cause of appendicitis: a case report

William Ngatchou1, Pierre Mols1, Ahmed S. E. Ramadan1, Michèle Ngassa2, Pierre Youatou Towo1

1Department of Emergency Medicine, St Pierre Hospital, 2Department of Gastroenterology, Brugmann Hospital, Université Libre de Bruxelles, Brussels, Belgium

Correspondence to: William Ngatchou. Department of Emergency Medicine, St Pierre Hospital, Université Libre de Bruxelles, Brussels, Belgium. Email: willyngatchou@yahoo.fr.

Abstract: Foreign body occlusion of appendices lumen is a quite rare cause of appendicitis due to foreign body. We present a case of a 63-year-old male who presented with right lower quadrant pain since 24 hours. Computed tomography (CT) demonstrated an acute appendicitis due to a metallic foreign body which was found to be a bullet.

Keywords: Gamble; appendicitis; bullet


Submitted Jul 15, 2014. Accepted for publication Aug 06, 2014.

doi: 10.3978/j.issn.2223-4292.2014.08.07


Introduction

Foreign body occlusion of appendices lumen is a quite rare cause of appendicitis due to foreign body (1,2)


Case report

A 63-year-old male presented to our department with a complaint of right lower quadrant pain of 1-day duration. The patient denied diarrhea, vomiting, hematuria and dysuria. Three weeks before, he says to have eaten heavy meal with a game and alcohol. The patient past medical history included, coronary artery disease, hypertension, hypercholesterolemia. Physical examination reveals shiver but no fever, a cardiac rhythm of 98 bpm and right lower quadrant pain tenderness. Laboratory tests showed a slight increase of white blood cell count at 10.6×109/L and C-reactive protein at 22.9 mg/L. The urine analysis was normal. Contrast enhanced computed tomography (CT) of pelvis demonstrated a thickened and inflamed appendix of 17 mm of diameter. The lumen was occluded by a metallic foreign body (Figure 1). The patient underwent laparoscopic appendicectomy. A histopathologic examination revealed acute necrosis appendicitis due to a weapon bullet.

Figure 1 Enhanced CT with bullet (small dashed arrow) at the neck of inflamed appendix (long dashed arrow). (A) Axial vue; (B) coronal vue. CT, computed tomography.

Disclosure: The authors declare no conflict of interest.


References

  1. Asad S, Bae K, Jeon KN, Cho JM, Shin TB, Joo YT, Kim HJ. Appendicitis caused by a foreign body of dental origin: diagnosis with ultrasonography. J Ultrasound Med 2007;26:967-70. [PubMed]
  2. Karegoudar JS, Prabhakar PJ, Anitha MR, Vijayanah V. Foreign body appendicitis in children: Case report. New Indian J Surg 2011;2:153.
Cite this article as: Ngatchou W, Mols P, Ramadan AS, Ngassa M, Youatou Towo P. Computer tomography imaging of an unusual cause of appendicitis: a case report. Quant Imaging Med Surg 2015;5(3):467-468. doi: 10.3978/j.issn.2223-4292.2014.08.07

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