A drawing pin, drill bit, several staples and a magnet: definitely not a simple case of appendicitis.

The sequalae of foreign body ingestion may present in a number of manners and are even more prone to difficulties when a history of foreign body ingestion is not apparent. An 8-year-old boy with a short history of abdominal pain and vomiting presented to the hospital after seeing his general practitioner. He had a history of developmental delay. Examination revealed lower abdominal peritonism and his blood tests revealed elevated inflammatory markers. The patient was initially diagnosed with acute appendicitis and proceeded to theatre. At operation, the patient had a normal appendix but two perforations of the small bowel were incidentally discovered. After theatre, the patient underwent an abdominal X-ray, which revealed a number of radiopaque objects in the rectum. He returned to theatre where a number of metallic objects and a magnet were manually retrieved from the patient's rectum. He made a full recovery and was discharged home a few days later.