SMF Schweizerisches Medizin-Forum 1424-4020 1424-3784 EMH Schweizerischer Ärzteverlag AG Farnsburgerstrasse 8 CH-4132 Muttenz 08481 10.4414/smf.2020.08481 Der besondere Fall Chirurgie und Kinderchirurgie Gastroenterologie und Hepatologie Infektiologie Kardiologie Radiologie Corps étranger intra-appendiculaire Truong Minh Khoa gilbert.truong@outlook.com Médecine | chemin du Crêt 2 | Morges | Vaud | 1110 | SWITZERLAND | +41792563515 Mathys Philippe Andreas philippe.mathys@hispeed.ch service de gastro-entérologie, Hôpitaux Universitaires de Genève Petermann David 04 11 2020 20 4546 655 657 Copyright: EMH Schweizerischer Ärzteverlag AG 2020 EMH Schweizerischer Ärzteverlag AG "Swiss Medical Forum" is an open access publication of EMH published in accordance with the terms of the Creative Commons licence attribution - NonCommercial - NoDerivatives 4.0 International. You are free to share, copy and redistribute the material in any medium or format under the following terms: Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use. NonCommercial — You may not use the material for commercial purposes. NoDerivatives — If you remix, transform, or build upon the material, you may not distribute the modified material. "Non-commercial" means not primarily intended for or directed towards commercial advantage or monetary compensation. The incorporation of publications in commercial products, the use of publications to advertise for commercial products or services and any other usage that directly or indirectly pursues commercial interests is subject to the express previous consent of the publishing house as part of a written agreement. Please send us your request in writing. Exact indication of the publication from which you would like to reproduce material and detailed information about its intended use help to facilitate and expedite request processing. <p>Introduction Intra-appendicular foreign bodies are rare events, with an estimated incidence of 5 cases per 10 million inhabitants per year. In this article we describe a case of appendicitis after impaction of an ingested foreign body. Clinical case A 56-year-old woman is admitted to the emergency ward because of low back pain and fever with a duration of ten days. She indicates the accidental ingestion of a dental bur during an intervention two weeks before, without spontaneous evacuation. CT-scan shows the foreign body in intra-appendicular location. An MRI is indicated for the diagnosis of spondylodiscitis but cannot be performed because of the metallic foreign body. After both unsuccessful conservative management and endoscopic extraction, the foreign body is finally removed with laparoscopic appendectomy. Antibiotic course is pursued for six weeks for treatment of spondylodiscitis and endocarditis caused by Streptococcus mitis bacteremia of dental origin. Discussion Because of high complication rate, management of intra-appendicular foreign bodies involves CT-scan imaging and endoscopic intervention. If unsuccessful, the object must then be removed by laparoscopic appendectomy. Conclusion Intra-appendicular foreign bodies are rare, but can cause significant complications. At first, endoscopy is suggested for their extraction. If unsuccessful, laparoscopic appendectomy remains the option of choice.</p>