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Published on: June 6, 2025
Intra-abdominal abscess caused by toothpick injury
Yu-Jang Su1, Yen-Chun Lai, Chang-Chih Chen
1Department of Emergency Medicine, Mackay Memorial Hospital, and Mackay Medicine, Nursing and Management College, Taipei 112, Taiwan. yjsu@ms1.mmh.org.tw
Summary
A swallowed toothpick caused severe epigastric pain and an abscess in a 42-year-old female. Surgical removal was necessary after endoscopic attempts failed, highlighting the risks of ingested foreign bodies.
Area of Science:
- Gastroenterology
- Surgical Case Reports
Background:
- Foreign body ingestion can lead to serious intra-abdominal complications.
- Accurate diagnosis and timely intervention are crucial for patient outcomes.
Observation:
- A 42-year-old female presented with persistent epigastric pain and fever.
- Endoscopy revealed an impacted toothpick in the duodenal bulb, which could not be removed.
- CT scan confirmed the foreign body and showed intra-abdominal abscess formation.
Findings:
- A toothpick, a common yet potentially dangerous foreign body, caused duodenal impaction and subsequent abscess.
- Laparotomy was required for successful foreign body removal when endoscopic methods failed.
- The patient recovered after surgical intervention and was discharged within 11 days.
Implications:
- This case underscores the importance of considering ingested foreign bodies in patients with unexplained abdominal pain and fever.
- It highlights the limitations of endoscopic removal for certain impacted foreign bodies and the necessity of surgical intervention.
- Awareness of cultural practices, like the Taiwanese belief about toothpicks and beer, may be relevant in understanding ingestion etiology.
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