Fatal sepsis from appendicitis caused by an impacted tooth

Field, Xavier; Burton, T. P.; Christey, Grant

doi:10.1093/jscr/rjac564

Cited by 2 publications

(1 citation statement)

References 12 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Foreign bodies as a possible cause of acute appendicitis have been described in several recent studies (most commonly part of bone or toothpick). Other less common foreign bodies such as earrings, needles, and dental objects have been described [23,24,27,[30][31][32]. A recent study describes how a detailed history revealed that the patient had swallowed a dental crown.…”

Section: Discussionmentioning

confidence: 99%

A Bizarre Cause of Acute Appendicitis in a Pediatric Patient: An Ingested Tooth

Pogorelić

Čohadžić

2023

Children

View full text Add to dashboard Cite

(1) Background: Among all possible causes, foreign bodies are the rarest cause of appendicitis in the pediatric population. In the majority of cases, ingested foreign bodies pass through the gastrointestinal tract without causing symptoms. However, those foreign bodies that pass through the lumen of the vermiform appendix cannot re-enter the colon and may cause acute appendicitis. So far, various foreign bodies have been described to enter the appendix and cause acute appendicitis, such as seeds, needles, toothpicks, plant material, or even hair. Tooth or dental implants as a cause of acute appendicitis have been described in only a few cases. To our knowledge, this is the first described case of the tooth causing acute appendicitis in the pediatric population. (2) Case presentation: A 14-year-old male patient presented to the emergency department complaining of pain in the right lower quadrant of the abdomen and vomiting that persisted for approximately 24 h. Until then, the patient was healthy and had no concomitant diseases. Physical examination revealed guarding and tenderness in the right lower abdominal quadrant. The white blood cell count was 17.1 × 109/L with a neutrophil count of 91.1% and a C-reactive protein of 39.3 mg/dL. Ultrasonography of the abdomen revealed a thickened, inflamed appendix with a diameter of 11 mm and free periappendicular fluid. A 9 × 6 mm foreign body at the base of the appendix was visualized. The patient was diagnosed with acute appendicitis, and an emergency laparoscopic appendectomy was performed on the same day. Intraoperatively, gangrenous appendicitis was noted and removed without complications. Upon examination of the removed specimen, it was determined that the patient’s appendicitis had been caused by an ingested tooth. As it later turned out, the patient had broken a lateral incisor while playing sports the day before admission without knowing that he had swallowed it. The patient recovered well and was discharged the day after surgery. (3) Conclusion: Although an extremely rare event, acute appendicitis can be caused by a swallowed tooth. This case highlights the importance of a thorough history in pediatric patients who present to the emergency department with suspected acute appendicitis to determine if there is a precipitating event that may have caused acute appendicitis.

show abstract

Section: Discussionmentioning

confidence: 99%

A Bizarre Cause of Acute Appendicitis in a Pediatric Patient: An Ingested Tooth

Pogorelić

Čohadžić

2023

Children

View full text Add to dashboard Cite

show abstract

Appendiceal Foreign Bodies in Adults: A Systematic Review of Case Reports

Abdalla¹,

Nour²,

Qasim³

et al. 2023

Cureus

View full text Add to dashboard Cite

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.

show abstract

Fatal sepsis from appendicitis caused by an impacted tooth

Cited by 2 publications

References 12 publications

A Bizarre Cause of Acute Appendicitis in a Pediatric Patient: An Ingested Tooth

A Bizarre Cause of Acute Appendicitis in a Pediatric Patient: An Ingested Tooth

Appendiceal Foreign Bodies in Adults: A Systematic Review of Case Reports

Contact Info

Product

Resources

About