Nicola Antonacci, Marcello Labombarda, Claudio Ricci, Salvatore Buscemi, Riccardo Casadei, Francesco Minni, Department of General and Emergency Surgery, General and Emergency Surgery Unit, S.Orsola-Malpighi Hospital, University of Bologna, 40100 Bologna, Italy.
World J Gastrointest Surg. 2013 Jun 27;5(6):195-8. doi: 10.4240/wjgs.v5.i6.195.
Foreign bodies are rare causes of appendicitis and, in most cases, ingested foreign bodies pass through the alimentary tract asymptomatically. However, ingested foreign bodies may sometimes remain silent within the appendix for many years without an inflammatory response. Despite the fact that cases of foreign-body-induced appendicitis have been documented, sharp and pointed objects are more likely to cause perforations and abscesses, and present more rapidly after ingestion. Various materials, such as needles and drill bits, as well as organic matter, such as seeds, have been implicated as causes of acute appendicitis. Clinical presentation can vary from hours to years. Blunt foreign bodies are more likely to remain dormant for longer periods and cause appendicitis through obstruction of the appendiceal lumen. We herein describe a patient presenting with a foreign body in his appendix which had been swallowed 15 years previously. The contrast between the large size of the foreign body, the long clinical history without symptoms and the total absence of any histological inflammation was notable. We suggest that an elective laparoscopic appendectomy should be offered to such patients as a possible management option.
异物是阑尾炎的罕见病因,在大多数情况下,吞食的异物会无症状地通过消化道。然而,吞食的异物有时可能在阑尾内多年没有炎症反应而保持沉默。尽管有文献记载了异物引起的阑尾炎病例,但尖锐和锋利的物体更有可能导致穿孔和脓肿,并在吞食后更快出现症状。各种材料,如针和钻头,以及有机物质,如种子,都被认为是急性阑尾炎的病因。临床表现可以从数小时到数年不等。钝性异物更有可能长时间潜伏,并通过阻塞阑尾腔引起阑尾炎。我们在此描述了一例 15 年前吞食异物的患者,其阑尾内有异物。异物体积大,临床病史长但无症状,且组织学无任何炎症,这种情况非常显著。我们建议对这类患者采取选择性腹腔镜阑尾切除术作为一种可能的治疗选择。