A shot to the gut: appendicitis triggered by retained buckshot

TL;DR

A man developed appendicitis due to retained lead pellets from buckshot, highlighting a rare cause of the condition and the risk of lead exposure.

Contribution

This case report highlights appendicitis caused by retained buckshot, a rare and under-recognized etiology.

Findings

Appendectomy confirmed two retained lead pellets and acute appendicitis.

The patient's history of game meat consumption may have contributed to the foreign body retention.

The case emphasizes the need to consider retained foreign bodies in appendicitis diagnosis.

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.

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