To report a rare case of acute suppurative appendicitis in a child with an incidental pelvic osseous foreign body detected on preoperative CT, highlighting the diagnostic challenges.
Approach:
Case Presentation: An 8-year-6-month-old girl presented with a 2-day history of intermittent abdominal pain and fever. Abdominal CT suggested acute appendicitis and revealed a linear hyperdense structure measuring approximately 4.0 cm located between the bladder and uterus.
Intervention: Emergency laparoscopic appendectomy was performed, during which a bone-like foreign body was identified at the pelvic peritoneal reflection and removed after obtaining informed consent.
Key Findings:
The foreign body was approximately 4.0 cm in length and located at the pelvic peritoneal reflection, without surrounding inflammation.
Histopathological examination of the foreign body was declined by the family, limiting understanding of its origin.
Postoperative recovery was uneventful, and the patient remained asymptomatic at follow-ups.
Interpretation:
The case highlights the importance of thorough assessment of incidental findings during pediatric acute abdomen management.
Limitations:
Histopathological analysis of the foreign body was not performed, which limits understanding of its nature.
There is limited literature on pediatric pelvic osseous foreign bodies, complicating clinical decision-making.
Conclusion:
Simultaneous management of incidental findings may be considered when clinically meaningful, following adequate evaluation and informed consent.
