The case of the forgotten toothbrush

Area of Science:

• Gastroenterology
• Surgical Pathology

Background:

• Foreign body ingestion is common, but toothbrush ingestion is rare.
• Small-bowel perforation from sharp foreign bodies is difficult to diagnose preoperatively due to nonspecific symptoms mimicking other surgical conditions.

Purpose of the Study:

• To report a rare case of a swallowed toothbrush causing terminal ileum perforation.
• To highlight the diagnostic challenges and differential considerations for foreign body ingestion.

Main Methods:

• Case report of a patient presenting with symptoms mimicking a diverticular abscess after swallowing a toothbrush.
• Review of literature on foreign body ingestion and bowel perforation.

Main Results:

• The swallowed toothbrush perforated the terminal ileum, presenting as a fluctuant mass, pyrexia, and generalized tenderness.
• The patient's presentation mimicked a diverticular abscess, delaying diagnosis.

Conclusions:

• Toothbrush swallowing is a rare cause of bowel perforation.
• Foreign body perforation can mimic acute appendicitis and diverticulitis, complicating clinical diagnosis.
• Radiological investigations may aid diagnosis, but surgical intervention is often required for confirmation.