PMC6000989_01
Abdominal X-Ray on day 4 showing 2 radiopaque fragments in the right iliac fossa which have not changed in position compared to previous.
gr1.jpg
PMC6000989_01_gr1.jpg
fig0005
Conservative management was initially attempted but the patient was persistently tender over the right iliac fossa, and the foreign bodies remained static in position on serial plain films Fig. 1.
CT slices showing the metallic objects in the right iliac fossa, however it was difficult to assess their precise location due to streak artefacts.
gr2.jpg
PMC6000989_01_gr2.jpg
fig0010
There were no features to suggest perforation Fig. 2.
Using image intensification, we were able to locate the razor blades in the appendiceal lumen.
gr3.jpg
PMC6000989_01_gr3.jpg
fig0015
After removal in a pouch (10 mm EndoCatch), the two blades were confirmed to be entirely within the specimen Fig. 3.
Specimen showing the transected appendix with the razor blades extracted.
gr4.jpg
PMC6000989_01_gr4.jpg
fig0020
Histological assessment showed foci of active inflammation in the lamina propria with cryptitis and neutrophils in surface of epithelium associated with haemorrhage which is consistent with early mucosal appendicitis Fig. 4.