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

Abstract

A perforation due to the ingestion of a toothpick is a condition seldom seen in the stomach. We herein describe an 80-year-old woman with a perforation of the stomach due to an ingested hollow toothpick. The toothpick was easily removed during a mini-laparotomy. The site of perforation was closed with absorbable sutures and omentum was used to function as an overlying patch. The postoperative course was uncomplicated. The hollow toothpick functioned as a fistula between the contents of the stomach and the peritoneal cavity. This resulted in a very different clinical picture from that observed in "classical wooden" toothpick injury, where the toothpick is not able to function as a fistula. To the best of our knowledge, this is the first description of a hollow toothpick perforating the stomach. A hollow toothpick perforation must be considered in any patient with symptoms of intestinal perforation, even when there is no history of swallowing toothpicks. Removal of a toothpick and subsequent suturing of the puncture site is a simple and relatively minor surgical procedure, which may have a lower morbidity and mortality as compared to other causes of gastric perforation. A precaution to observe, is the potential danger that one of the members of the operating team might perforate a finger.

Duodenal Perforation and Right Hydronephrosis Due to Toothpick Ingestion

“…That case was interesting due to the absence of symptoms during and after perforation of the gastric wall, probably due to very slow migration of the toothpick. Risk factors for toothpick ingestion are mental retardation, alcohol abuse, dental prosthesis, rapid eating, and habitual chewing of toothpicks (7)(8)(9). Only 12% of patients recall toothpick ingestion.…”

An unusual cause of small bowel perforation: apricot pit

“…[5][6][7] Those most commonly associated with complications are toothpicks, fish and chicken bones and needles. [6,[8][9][10][11][12] Although most of the sharppointed objects entering the stomach will pass through the remaining gastrointestinal tract without incident, the risk of complication caused by a sharp-pointed object is as high as 35%. [13] Sharp, pointed foreign bodies often cause perforations in the gastrointestinal tract; endoscopic removal is advisable if they are within the reach of available endoscopes.…”

Right-Sided Hydronephrosis Secondary to Swallowing a Headscarf Pin

“…Nonetheless, chronic inflammation is not uncommon, resulting in abscess or granuloma formation [7]. Risk factors for the FB ingestion are mental retardation, alcohol abuse, dental prosthesis, rapid eating, and habitual chewing of toothpicks [8]. We present a healthy young woman with right flank pain and nausea which started 3 weeks earlier but there were no abdominal abscess symptoms.…”