Endoscopic extraction of food bolus impaction and foreign body ingestion from the upper digestive tract is successful in 95% of cases.2 17 When endoscopic extraction fails, rigid oesophagoscopy for the upper oesophageal foreign body can be considered. Based on the review, an algorithm for the management of toothpick ingestion was developed by Steinbach et al. Patients most commonly present either with bowels obstruction or with complications related to perforation, migration, and intraabdominal fistulas 12. The most frequent site of injury from ingested toothpicks is duodenum, followed by sigmoid colon[ 4 ]. Tel: 009611441822; Fax: 009611441822; E‐mail: antoine.el.asmar@gmail.com, General and Digestive Surgery, Breast Oncologic Surgery and Reconstruction, Saint Georges Hospital University Medical Center, Faculty of Medicine, University of Balamand, Beirut, Lebanon, General and Digestive Surgery, Oncologic Surgery, Saint Georges Hospital University Medical Center, Faculty of Medicine, University of Balamand, Beirut, Lebanon. and you may need to create a new Wiley Online Library account. The toothpick was successfully removed by snare extraction without complications. The toothpick caused gut perforation in 79 % of all patients. The patient did well and was discharged on post-operative day 7. Endoscopy showed success mainly when the toothpick location was the stomach (75%), duodenum (70%), and large bowels (45%). -, Intensive Care Med. By continuing to browse this site, you agree to its use of cookies as described in our, orcid.org/http://orcid.org/0000-0002-6635-4616, I have read and accept the Wiley Online Library Terms and Conditions of Use, Endoscopic Management of Foreign Bodies in the Gastrointestinal Tract: A Review of the Literature, Management of foreign bodies in the gastrointestinal tract: an analysis of 104 cases in children, Management of ingested foreign bodies in childhood: our experience and review of the literature, The management of ingested foreign bodies in children‐a review of 663 cases, Dental prosthesis ingested and impacted in the esophagus and orolaryngopharynx, Management of ingested foreign bodies and food impactions, Foreign body ingestions in the Emergency Department: case reports and review of treatment, Ingested foreign bodies of the gastrointestinal tract: retrospective analysis of 542 cases, Liver abscess caused by toothpick and treated by laparoscopic left hepatic resection: case report and literature review, Sonographic diagnosis of a toothpick traversing the duodenum and penetrating into the liver, Toothpick inside the common bile duct: a case report and literature review, Toothpick perforation of the intestines presenting as recurrent abdominal pain: possible roles of abdominal ultrasound and MRI, Fever of unknown origin due to intrahepatic wooden toothpick, Small bowel obstruction caused by the ingestion of a wooden toothpick: the CT findings and a literature review, Enterovesical fistula caused by a toothpick, Trans‐colonic foreign body penetration of the retro‐hepatic vena cava. Successful Endoscopic Removal of Toothpick Perforating Gastric Antrum With Over-the-Scope Padlock Clip Closure. MANAGEMENT Airway Initial management includes assessment of the patient’s ventilatory status and an airway evaluation. Patients will report a history of recurrent abdominal pain, fever of unknown origin, like our patient, nausea, obstipation, diarrhea etc. day after ingestion, and the toothpick appeared as a distinct low density linear structure (11). We report here, for the first time to our knowledge, a retroperitoneal and thigh cellulitis secondary to colonic perforation due to toothpick ingestion. This is the case of a 61‐year‐old female patient, previously healthy, presenting with 2 months history of myalgias, arthralgias, fatigue, and abdominal discomfort. If endoscopy is not rapidly available and severe injury is strongly suspected, obtain a … Management. Learn more. USA.gov. 13-17. 2002 Jul;23(1):35-8. doi: 10.1016/s0736-4679(02)00458-4. 1955 Nov 1;55(21):3115-9 We have reported a case of small bowel obstruction due to the accidental ingestion of a toothpick. doi: 10.7759/cureus.11263. Toothpick ingestion is a medical emergency. Toothpick ingestion is a relatively rare event that may results in serious gut injuries with peritonitis, sepsis or even death. Toothpick and bone ingestions have a high risk for perforation and are the most common foreign bodies that require surgical removal . When informed of this unusual finding during his follow-up, he recalled the probable accidental ingestion of a toothpick after drinking. After adhesionlysis, the hepatic flexure of the colon was found adherent to segment V of the liver. The surgeon should be prepared for life‐threatening situations such as major vascular involvement, as well as highly specialized and technically challenging procedures, when the hepatic hilum is involved for instance. The diagnostic procedures included endoscopy (63 %), computed tomography scan (63 %), and ultrasound (47 %); however, in 35 % of cases these investigations failed to detect the toothpick. The patient was kept NPO for 5 days then diet was resumed. 2020 Jul 9;7(7):e00420. 1. Endoscopic Management of Colonic Perforation due to Ingestion of a Wooden Toothpick. We then performed a retrospective analysis of patients' characteristics, medical history, diagnostics, therapy, and clinical outcome. Carlos Manterola 1 2 1 Programa de Doctorado en Ciencias Médicas, Universidad de La Frontera, Temuco, Chile. REVIEW Open Access Toothpick ingestion complicated by cecal perforation: case report and literature review Andrea Lovece1, Emanuele Asti1,2*, Andrea Sironi1 and Luigi Bonavina1 Abstract Background: Diverticulitis and carcinoma represent the most common causes of colon perforation, but other More than half of all cases go unnoticed by patients (54%) and lead to perforations in almost 80% of all cases. Sarici IS(1), Topuz O(2), Sevim Y(2), Sarigoz T(2), Ertan T(2), Karabıyık O(3), Koc A(3). J Emerg Med. Management. The approach to toothpick ingestion and its complications should not be underestimated. 9. CT‐scan showing the abscess (thick white arrows) with coronal cuts showing fat stranding communicating the colonic hepatic flexure all the way to the segment V of the liver reaching the abscess cavity (thin white arrows). Unlike other foreign bodies, the ingestion of a toothpick is very uncommon and carries high morbidity and mortality rates. National Center for Biotechnology Information, Unable to load your collection due to an error, Unable to load your delegates due to an error. Foreign body ingestion is responsible for around 1500 cases of death in the United States every year 1. The role of laparoscopy was still limited to the extraintestinal and small bowel locations (20%), and large bowels (10%). BACKGROUND: Toothpick ingestion is implicated in bowel injuries that may cause violent complications, mimicking diseases causing acute abdomen. BackgroundDiverticulitis and carcinoma represent the most common causes of colon perforation, but other causes, like ingestion of foreign bodies, should be taken into account.Case presentationWe report the case of a 64-year old man presenting in our Emergency Department with a 2 days history of right lower abdominal pain, nausea, vomiting and low grade fever. Around 136 cases of toothpick ingestion causing gastrointestinal perforation have been reported, of which more than 15 presented with migration into the liver necessitating surgical management 10, 11. Long‐standing fever with no origin or focus, abdominal pain, obstruction, perforation in young healthy patients etc. Foreign bodies ingestion can sometimes be difficult to diagnose. YP: gathered the clinical data, did the literature review, and assisted in the surgical intervention. Adequate therapy depends on localization of the toothpick in the gastrointestinal tract. At this point, surgical intervention was decided. Perforations of the intestine are common and the associated mortality is high. In childhood, almost all swallowed objects that successfully navigate the esophagus pass through the gut without complications. CASE REPORT: A 18-year-old man was admitted with a 3-day history of a swallowed wooden toothpick.The patient had tenderness in the left flank area. Upon reexploration, no overt perforation in the colon was identified, so we decided to put few imbrication sutures along the previously adherent serosa. Toothpick ingestion is a medical emergency. Necrotizing fasciitis from an iliopsoas muscle abscess caused by a toothpick: A case report and literature review. Of Balamand Beirut Lebanon foreign object was also suspected within the abscess cavity: case presentation, management, relation. Clinical suspicion should be kept in mind as an important differential diagnosis in patients with acute abdominal pain foreign! The abdomen Perforating Gastric Antrum with Over-the-Scope Padlock Clip Closure in most cases 58. Conclusion toothpick ingestion without awareness is rare but fatal ( 02 ) 00458-4 suspicion should be considered obstruction. Iliopsoas muscle abscess caused by toothpick ingestion fine dissection was carried out at first, white! 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