Asymptomatic Gastric Perforation by a Toothpick

Abstract

Background: Many cases of gastric perforation with peritonitis, pylephlebitis, hepatic abscesses, or lethal bleeding, caused by ingested long and sharp objects, are reported in the literature. Methods: During a right hepatectomy for a giant hemangioma, a wooden toothpick was found between the two layers of the hepatogastric ligament. It was not possible to find the passage of the foreign body through the gastric wall. The patient did not report any correlated symptoms. Results: There was no sign of inflammation around the toothpick, which was enveloped in thin scar tissue. The removal of the foreign body was performed without complications. Conclusions: The peculiarity of our case is the total absence of symptoms during and after the perforation. Despite the benign evolution of our case, toothpicks must be considered as potentially dangerous, like other pointed objects, and, therefore, removed immediately.

Careless Use of Turban Pins: A Possible Problem for Turbaned Patients

“…It usually presents with peritonitis, although in some cases the perforation may seal spontaneously and the patient remains asymptomatic; in other cases, an intraabdominal abscess may develop. [13][14][15] In our two patients with partial or complete stomach wall perforation, there were no notable symptoms of irritation or upset.…”

Gastric Perforation Due to the Ingestion of a Hollow Toothpick: Report of a Case

“…8 Perforation can also be asymptomatic, causing later complications in adjacent organs. 4 Peristalsis of the intestinal tract will propel the toothpick through the intestinal wall, which can lead to migration to other organs close to the perforating site, thereby demonstrating a very different clinical pathology such as constrictive pericarditis. 4,[9][10][11] A diagnosis is most frequently made during an explorative laparotomy; however, a preoperative diagnosis using ultrasound, computed tomography, and upper gastrointestinal studies has also been reported.…”

“…4 Peristalsis of the intestinal tract will propel the toothpick through the intestinal wall, which can lead to migration to other organs close to the perforating site, thereby demonstrating a very different clinical pathology such as constrictive pericarditis. 4,[9][10][11] A diagnosis is most frequently made during an explorative laparotomy; however, a preoperative diagnosis using ultrasound, computed tomography, and upper gastrointestinal studies has also been reported. 3 In the literature, previous cases of intestinal toothpick perforation failed to show evidence of free intraperitoneal gas on plain abdominal and chest X-rays, 12 in contrast to our case.…”

“…3 A gastric perforation can cause acute symptoms with signs of peritonitis, but also with spontaneous closure of the puncture hole with later complications of the wandering toothpick. 4 We herein present a rare case of perforation of the stomach with a double-pointed hollow plastic toothpick, producing an acute abdomen with air and gastric contents in the peritoneal cavity.…”

Leberabszess nach Perforation eines Zahnstochers durch die Magenwand

“…Further, ten ingested toothpicks [9, [38][39][40][41][42][43][44][45][46] and 1 per item of clothespins [9], wires [8], pens [47] and toothbrushes [48] have been reported (6 adults, 8 without age indication). In 24 cases, the foreign body could not be identified from the literature (3 adults, 3 pediatric, rest without age indication) [7, 8, 49-70].…”