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Toothpick-induced aortoenteric fistula presenting as sepsis
Elizabeth Liao1, Martin Simons2, Leonard W Tse3
1Faculty of Medicine, University of Toronto, Toronto, Canada.
BMJ Case Reports
|June 15, 2017
Summary
A rare aortoenteric fistula (AEF) caused by a toothpick led to sepsis. This case highlights foreign body ingestion as a cause of AEF, requiring complex medical intervention.
Area of Science:
- Gastroenterology
- Vascular Surgery
- Infectious Disease
Background:
- Aortoenteric fistulas (AEF) are rare but life-threatening conditions causing gastrointestinal bleeding.
- Primary AEF, where a foreign body erodes into the aorta, is exceptionally uncommon.
Observation:
- A 47-year-old male presented with symptoms of gastrointestinal bleeding.
- The patient was diagnosed with a primary AEF caused by toothpick ingestion.
- He also presented with polymicrobial sepsis and bilateral pulmonary septic emboli.
Findings:
- This is the 10th reported case of a foreign body causing an AEF.
- It is the first documented case of a toothpick causing such a fistula.
- The patient required extensive medical treatment, including multiple interventions and prolonged ICU care.
Implications:
- Foreign body ingestion should be considered in the differential diagnosis of AEF.
- Prompt diagnosis and management are crucial for patient survival.
- This case expands the understanding of rare causes of aortoenteric fistulas.
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