A 54-year-old man was seen at the hospital because of lower abdominal dull pain lasting for about one month. On physical examination a tumor about 5cm in diameter was palpated in the right lower abdomen where he complaind of the pain. Barium enema study and colonoscopic fiber revealed remarkable thickening of mucosa. CT visualized a tumor with malignant suspicion in the ileocecal region. The patient was operated on with a strong suspicion of malignant tumor of the ileocecal region. It was found that the appendix firmly adhered to the surrounding organs and the ileocecal region formed a mass. The top of the apendix dissolved due to inflammation and a fish bone about 3cm in length was confirmed in the same portion. The fish bone was easily removed. No tumor was found in the ileocecal region and an appendectomy was performed.
This case of localized peritonitis with a long course is rare. It is thought that the aberrated fish bone to the appendix caused appendicitis with perforation, but the inflammation was localized by the firm adhesions of the surrounding organs including the intestine and retoperitoneum because of dosal dislocation of the appendix, leading to the course of such a long duration.