Variable FB have been documented [6, 9, 16] even the bizarre case of an appendicitis due to a condom fragment . Risk factors includes; the low position of the cecum and its low motility, FB weighter than the fecal matter, as well as the size of the appendicular orifice [3, 5, 6, 15]. Once a FB has entered the appendicular lumen the peristalsis is insufficient to expel it. The time for apendicitis debut since ingestion is variable, round objects have larger periods (years), while sharp FB cause problems in shorter times [4, 5, 6, 10]. Our patient has an atypical behavior by not presenting appendicitis at the time of diagnosis.
Diagnosis of FB is relatively easy, the method of choice is computed tomography (CT), the only limitation is the interpretation of radiologist. CT has a greater diagnostic precision than the abdominal x-ray and the use of contrast CT is recommended in cases in which complications such as perforation, etc. are suspected [2, 3].
Management is controversial, however, due to the high risk of complications, laparoscopic or open appendectomy should be performed [2, 5]. Our surgical team performed an open appendectomy for safety . The patient was discharged 2 days after with no complications and the histopathological reported no inflammatory changes.
FB in the caecal appendix is a rare entity, in most cases the diagnosis is made when the patient has already presented appendicitis; however, it not always follow the usual course. A FB located in the right lower quadrant should make us suspect an appendiceal location, which must be confirmed by an abdominal CT and timely inform the surgeon to avoid the complications.
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