위장관내 이물은 대부분 자연적으로 배출되지만 길고 날카로우며 단단한 금속성 물질은 다양한 합병증을 유발한다. 따라서 신속하게 내시경으로 제거를 하는 것이 최선이다. 그러나 초기에 이물 제거에 실패하면 복부 방사선 검사로 주의깊게 경과관찰을 해야 한다. 이물이 우하복부에 고정되어 변화가 없으면 대장내시경을 이용하여 제거를 시도해야 하며 이러한 방법에도 실패하면 복강경을 이용한 수술 제거가 시행되어야 한다. 저자들은 치과 치료 중 우연히 치근관 파일을 삼켜 내원한 환자에서 이물이 충수 돌기에 저류된 것을 확인하고 합병증이 발생하기 전에 복강경을 통한 충수 돌기 제거술로 이물을 제거한 예를 경험하였기에 문헌고찰과 함께 보고한다.

Once ingested foreign bodies pass through the stomach, 80 to 90 percent of them will exit via the gastrointestinal tract and they are excreted naturally in 7-10 days; surgical treatment is not required in most case. But once foreign bodies permeate the appendix, it is difficult for them to be excreted again to the cecum; therefore, this can possibly cause appendicitis or perforation. Especially in case of long, pointed, thin, stiff, sharp and/or metalic objects, the risk of perforation will increase. We attempted to remove an endodontic file in the appendix by colonoscopy. This was done in a patient who came to hospital because he swallowed an endodontic file during endodontic therapy. But we failed to retrieve it, and so we got rid of the foreign body by performing elective surgery before the occurrence of complications. We report here on surgical removal of an apppendiceal foreign body along with a review of the literature.(Korean J Med 72:209-212, 2007)

Once ingested foreign bodies pass through the stomach, 80 to 90 percent of them will exit via the gastrointestinal tract and they are excreted naturally in 7-10 days; surgical treatment is not required in most case. But once foreign bodies permeate the appendix, it is difficult for them to be excreted again to the cecum; therefore, this can possibly cause appendicitis or perforation. Especially in case of long, pointed, thin, stiff, sharp and/or metalic objects, the risk of perforation will increase. We attempted to remove an endodontic file in the appendix by colonoscopy. This was done in a patient who came to hospital because he swallowed an endodontic file during endodontic therapy. But we failed to retrieve it, and so we got rid of the foreign body by performing elective surgery before the occurrence of complications. We report here on surgical removal of an apppendiceal foreign body along with a review of the literature.(Korean J Med 72:209-212, 2007)

Foreign bodies, Appendix, Endodontic instruments, Surgical Procedures