Impacted wooden toothpick in the stomach

Area of Science:

• Gastroenterology
• Emergency Medicine
• Toxicology

Background:

• Acute epigastric pain is a common presenting complaint in emergency departments.
• Foreign body ingestion can lead to significant gastrointestinal morbidity.
• Patient history may not always elicit a clear account of ingestion, especially with sharp objects like toothpicks.

Purpose of the Study:

• To highlight the importance of considering foreign body ingestion in cases of acute epigastric pain.
• To emphasize that a lack of patient recall or specific risk factors does not exclude foreign body ingestion.
• To raise awareness among clinicians, particularly in regions with prevalent toothpick usage.

Main Methods:

• This study reviews clinical presentations and diagnostic challenges associated with foreign body ingestion presenting as acute epigastric pain.
• Case series analysis and literature review were employed.
• Diagnostic modalities and management strategies are discussed.

Main Results:

• Foreign body ingestion, particularly toothpicks, can manifest as acute epigastric pain without a clear history of ingestion.
• Delayed diagnosis can lead to complications such as perforation or obstruction.
• High prevalence of toothpick use in certain regions increases the likelihood of such ingestions.

Conclusions:

• Foreign body ingestion should remain a differential diagnosis for acute epigastric pain, irrespective of patient history or perceived risk factors.
• Clinicians must maintain a high index of suspicion, especially in endemic areas of toothpick use.
• Prompt recognition and management are crucial to prevent severe gastrointestinal complications.