Acute Appendicitis Secondary to Fish Bone Perforation Managed by Laparoscopic Appendectomy: a case report

Abstract

We report a 48-year-old male of perforated appendicitis induced by fish bone. The patient experienced persistent right lower abdominal pain for 24 hours with no response to antibiotics. Physical examination revealed localized tenderness, with rebound pain at McBurney's point. Ultrasound scan confirmed acute appendicitis. Emergency laparoscopic surgery revealed that the culprit behind the appendicitis was a fishbone, which had pierced the wall of the appendix. The retrospective analysis of the patient's dietary history indicated that he had consumed fish and swallowed a fish bone within 72 hours prior to symptom onset. We identified three measures that can improved diagnostic rates for patients through this case. 1) Mandatory surgical intervention for patients exhibiting peritoneal irritation signs. 3) Systematic dietary history documentation should be prioritized in endemic regions. 2) Enhanced CT with three-dimensional reconstruction improves detection of submillimeter foreign bodies. Laparoscopic appendectomy emerges as the optimal therapeutic approach, combining diagnostic confirmation with definitive treatment, particularly valuable in occult foreign body cases.