title: Bullet fragment within the appendix: a case report.
abstract: A 9-year-old Caucasian male presented initially to his pediatrician with abdominal pain. The child underwent a UGI, which showed mild gastric erosions, however the scout film revealed a metal fragment lodged near the right sacroiliac joint on the AP view. The child was referred to a general surgeon who conducted a series of other diagnostic tests, which ultimately revealed and verified that the metal fragment was lodged in the distal appendix. Careful family history obtained showed that the family eats a great deal of wild game, including deer meat. It was felt that this metal fragment was a portion of a consumed bullet, which was retained in the appendix. The child's blood lead (Pb) level was elevated at 16ug/dl. An elective prophylactic appendectomy was performed due to the potential for developing appendicitis and possible lead toxicity.
authors.affiliation: Hartsville Surgical Center; 704 Medical Park Drive, Hartsville, SC 29550, USA.
authors.forename: Thomas V
authors.initials: TV
authors.lastname: Mincheff
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D001062:Appendectomy; D001065:Appendix / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D002648:Child; D004435:Eating; D005547:Foreign Bodies / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008460:Meat; D014057:Tomography, X-Ray Computed