Elmansi Abdalla Hashim E, Nour Hussameldin M, Qasim Muhammad, Magsi Abdul Malik, Sajid Muhammad S
Department of General Surgery, New Cross Hospital, Wolverhampton, GBR.
Department of Digestive Disease and General Surgery, Royal Sussex County Hospital, Brighton, GBR.
Cureus. 2023 Jun 8;15(6):e40133. doi: 10.7759/cureus.40133. eCollection 2023 Jun.
Adults can accidentally swallow foreign bodies (FBs) with food. In rare occasions, these can lodge in the appendix lumen causing inflammation. This is known as foreign body appendicitis. We conducted this study to review different types and management of appendiceal FBs. A comprehensive search on PubMed, MEDLINE, Embase, Cochrane Library and Google Scholar was performed to detect appropriate case reports for this review. Case reports eligible for this review included patients above 18 years of age with all types of FB ingestion causing appendicitis. A total of 64 case reports were deemed to be eligible for inclusion in this systematic review. The patient mean age was 44.3 ± 16.7 years (range, 18-77). Twenty-four foreign bodies were identified in the adult appendix. They were mainly lead shot pellet, fishbone, dental crown or filling, toothpick, and others. Forty-two percent of the included patients presented with classic appendicitis pain, while 17% were asymptomatic. Moreover, the appendix was perforated in 11 patients. Regarding modalities used for diagnosis, computed tomography (CT) scans confirmed the presence of FBs in 59% of cases while X-ray only managed to detect 30%. Almost all of the cases (91%) were treated surgically with appendicectomy and only six were managed conservatively. Overall, lead shot pellets were the most common foreign body found. Fishbone and toothpick accounted for most of the perforated appendix cases. This study concludes that prophylactic appendicectomy is recommended for the management of foreign bodies detected in the appendix, even if the patient is asymptomatic.
成年人可能会在进食时意外吞下异物。在极少数情况下，这些异物会滞留在阑尾腔内引发炎症。这被称为异物性阑尾炎。我们开展这项研究以回顾阑尾异物的不同类型及处理方法。我们在PubMed、MEDLINE、Embase、Cochrane图书馆和谷歌学术上进行了全面检索，以查找适合本综述的病例报告。符合本综述的病例报告包括年龄在18岁以上、因各种类型的异物摄入导致阑尾炎的患者。共有64篇病例报告被认为符合纳入本系统综述的条件。患者的平均年龄为44.3±16.7岁（范围为18 - 77岁）。在成人阑尾中发现了24种异物。它们主要是铅弹、鱼骨、牙冠或补牙材料、牙签等。纳入研究的患者中，42%表现为典型的阑尾炎疼痛，而17%无症状。此外，11例患者阑尾穿孔。关于诊断方式，计算机断层扫描（CT）在59%的病例中证实了异物的存在，而X线仅能检测出30%。几乎所有病例（91%）都接受了阑尾切除术的手术治疗，只有6例采取了保守治疗。总体而言，铅弹是最常见的异物。鱼骨和牙签占阑尾穿孔病例的大部分。本研究得出结论，对于在阑尾中检测到的异物，即使患者无症状，也建议进行预防性阑尾切除术。
