Ingested Lamb Bone Presented as Right Iliac Fossa Pain Mimicking Acute Appendicitis

Abdominal pain is a frequent presentation encountered by the primary care physician. Acute appendicitis accounts for a small but significant proportion of abdominal pain cases seen. Among the known etiologies mimicking appendicitis, foreign-body ingestion is exceedingly rare and may be easily misdiagnosed as another cause of acute abdomen and lead to the need for emergency surgery. It might be challenging to establish a diagnosis if the patient cannot recollect having swallowed the foreign body. We report an interesting case of a 50-year-old female who presented with complaints of severe abdominal pain, nausea, and anorexia. Physical examination revealed marked tenderness in the right iliac fossa. To further confirm the diagnosis of acute appendicitis, computed tomography (CT) abdomen was done that finally revealed a normal appendix but a lodged bone at the cecal pole, thus mimicking acute appendicitis. When other causes of stomach discomfort have been ruled out, including an unremarkable patient history, it is important to keep foreign-body ingestion as a differential. CT scan is an imaging modality that should be offered when the diagnosis is not clear.