A Foreign Body in an Unexpected Place—Ingested Hardware Nails Within the Appendix

Abstract

Foreign body ingestion is commonly encountered in clinical practice, with over 100,000 cases reported annually in the United States. The majority of objects pass through the gastrointestinal tract spontaneously and without consequence, with fewer than 1% of objects requiring surgical intervention. Foreign bodies have rarely been found lodged within the appendix. We report the therapeutic management of a young patient who ingested over 30 hardware nails. The patient originally underwent an esophagogastroduodenoscopy with attempted removal from the stomach and duodenum, though only 3 nails were successfully extracted. The patient was able to excrete all but 2 of the nails that remained localized to the right lower quadrant without perforation to their gastrointestinal tract. Laparoscopic exploration with fluoroscopic guidance was performed and both foreign bodies were found lodged within the appendix. The patient made an uneventful recovery after laparoscopic appendectomy.