A Case of Foreign Body in the Appendix by a Clip Used For Endoscopic Therapy

Abstract

The patient was a woman in her 50s who had undergone endoscopic resection of a polyp in the cecum. Four days after the procedure, she visited our hospital complaining of lower right abdominal pain, and physical examination revealed signs of peritoneal irritation. Abdominal CT showed inflammation in the polyp resection area, and one of the clips used during the procedure was detected in the appendix, without any evidence of inflammation. Although diagnosing the cause of the abdominal pain and selecting the appropriate treatment plan posed a challenge initially, appendectomy was performed after initial conservative treatment. This seems to be the first reported case of retention of an endoscopic clip in the appendix without evidence of inflammation. It was unclear if automatic passage from the appendix could be expected. Because the clip was relatively sharp and therefore a potential cause of perforation, we decided to perform appendectomy.