PMC6326104_01
(A) Abdominal X-ray with a radiopaque metallic foreign body. (B) Abdominal CT, the metallic foreign body is lodged in the appendix. (C) Abdominal CT, the appendix is surrounded by homogeneous non-inflamed fat and contains intraluminal air.
rjy335f01.jpg
PMC6326104_01_rjy335f01.jpg
rjy335F1
A metallic foreign body (30 mm nail) was discovered in his lower right abdomen (Fig. 1A). A colonoscopy was requested to assess the cecum to try to remove the foreign body, however, after reaching the cecum and the appendix the nail could not be found (Fig. 1B). The surgical decision was straightforward, the appendix was resected, and the surgery was completed without complications (Fig. 1C).
(A) Colonoscopy, the appendiceal orifice is seen without the foreign object. (B) Intraoperative abdominal x-ray confirming the presence of the nail in the appendix. (C) Appendix during surgery.
rjy335f02.jpg
PMC6326104_01_rjy335f02.jpg
rjy335F2
With these findings, a contrast-enhanced abdominal computed tomography (CT) revealed the presence of a 30 mm metal nail inside his appendix (Fig. 2A). An intraoperative abdominal x-ray was needed, which confirmed the presence of the nail in the appendix (Fig. 2B).
(A) Completely resected appendix. (B) Appendix and metallic nail.
rjy335f03.jpg
PMC6326104_01_rjy335f03.jpg
rjy335F3
The appendix had an outer diameter of 5 mm and was surrounded by homogeneous, non-inflamed fat and contained intraluminal air (Fig. 3A). After a Rocky-Davis incision, the appendix was exposed and an object of hard consistency was found at its tip (Fig. 3B).