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A shot to the gut: appendicitis triggered by retained buckshot

Year: 2025

Type: article

Abstract: Acute appendicitis is a common surgical emergency, most often caused by luminal obstruction from fecaliths. Rarely, foreign body ingestion can lead to appendicitis, particularly when small objects like lead shot become lodged in the appendix. We present the case of a 30-year-old man with chronic intermittent right lower quadrant pain who presented with an acute exacerbation. Imaging revealed two metallic densities in the appendix without overt signs of inflammation. He underwent laparoscopic appendectomy, which confirmed the presence of two retained lead pellets and histologic evidence of acute appendicitis. The patient had a history of frequent game meat consumption. This case underscores a rare but important etiology of appendicitis and the potential for systemic lead exposure from retained foreign bodies. In patients with relevant social histories and suggestive imaging, clinicians should consider this diagnosis and proceed with timely surgical management to prevent complications.

Source: Journal of Surgical Case Reports

DOI: 10.1093/jscr/rjaf423

Authors: Georges Kaoukabani, Roberto Alva-Ruiz, Omair Shariq, Joseph T Carroll, John M Zietlow

Institution: Mayo Clinic

Language: English

Topic: Appendicitis Diagnosis and Management

Subfield: Emergency Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $1,000