Cecal Perforation Caused by an Ingested Fishbone Discovered During Laparoscopic Appendectomy for Suspected Acute Appendicitis: A Case Report

Ingested foreign bodies are not uncommon but are usually excreted naturally without any symptoms.Sharp objects like fishbones can impact and perforate the bowel.Ileo-caecal fishbones present with symptoms mimicking acute appendicitis.A young man presented in the emergency room with pain in the right lower quadrant of the abdomen with tenderness and rebound tenderness.Contrast-enhanced CT (CECT) was not conclusive of acute appendicitis.No fishbone was identified preoperatively or on retrospective CT review.Laparoscopic examination showed a fishbone perforating the cecum and an inflamed appendix.Appendectomy was done; the fishbone was retrieved, and the punctate perforation was repaired.Histological examination of the appendix confirmed intact mucosa and mantle zones with multiple reactive lymphoid follicles, suggesting secondary appendicitis.The patient recovered well without complications.