Nail in the appendix: Asymptomatic foreign body lodging detected by imaging

Foreign body ingestions are relatively common and often pass through the gastrointestinal tract without complications. Asymptomatic lodging of a foreign body within the appendix, particularly in adults, is exceedingly rare and has only been described in a handful of cases. Ingestion of sharp or elongated objects, however, can result in impaction, perforation, or other complications. We present the case of a 55-year-old female who accidentally ingested a metallic nail, which ultimately lodged in her appendix. Despite being completely asymptomatic, serial radiographs and computed tomography confirmed the position of the nail in the right lower quadrant. The patient underwent elective laparoscopic appendectomy, and histopathological examination revealed active appendicitis. This case illustrates the importance of serial imaging, particularly CT, in tracking sharp foreign bodies and detecting silent complications.