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Updated: Jun 25, 2026

Gastric Point of Care Ultrasound in Adults: Image Acquisition and Interpretation
Published on: September 22, 2023
Unusual differential diagnosis of upper abdominal pain
Monika Lanthaler1, Thomas Grissmann, Lukas Schwentner
1Department of General and Transplant Surgery, Innsbruck Medical University Hospital, Anichstrasse 35, 6020 Innsbruck, Austria.
Abstract:
We here present an interesting unusual case of upper abdominal pain. The patient was a 38-year-old man, who was admitted to our hospital complaining of right upper quadrant pain caused by a toothpick that perforated the anterior gastric wall and penetrated segment I of the liver. After endoscopic removal and an initially uneventful course, computed tomography revealed a perigastric abscess that was treated by repeated gastroscopic rinsing via an endoscopically placed catheter. After another three uneventful weeks, a liver abscess with minor tendency to constrict the portal vein was diagnosed, and a segment I liver resection together with abscess drainage was performed. The peculiarity of this case is the rarity of toothpick ingestion and gastric perforation in a young and healthy white Caucasian followed by development of a liver abscess after primary uneventful endoscopic removal. In light of this case, gastric perforation due to ingested foreign bodies such as toothpicks can be considered a rare cause of upper abdominal pain.
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