Abstract
An artificial tooth swallowed in error caused appendiceal abscess 2 years later. This case is described with reference to the literature. A 47-year-old man was presented with lumbago and fever, as well as right lower abdominal pain, which had been disregarded. Physical examination revealed knock pain over the right lumber region, tenderness and peritoneal signs in the right lower quadrant. The body temperature was 38.2°C with a leukocyte count of 12500. Microscopic hematuria was not recognized. Abdominal radiography revealed a radiopaque foreign body, 10×8 mm in size, in the right lower quadrant. Enhanced CT disclosed a uniform low density area in the right ileopsoas muscle with a high density spot in the retroperitoneal cavity. An emergency operation was performed under a diagnosis of appendiceal abscess due to a foreign body. An appendix showing inflammatory swollen was extensively adhesive to the retroperitoneum and ileopsoas muscle.There was an egg-sized abscess in the ileopsoas muscle. Appendectomy was completed with drains left in the peritoneal cavity and abscess. The excised appendix contained the artificial tooth which had been swallowed 2 years before. This experience suggested the importance of a careful study on anamnesis and abdominal plain films for diagnosing appendicitis due to foreign bodies before operation.
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