Toothpick perforation of the intestines

Area of Science:

• Gastroenterology
• Surgical Pathology

Background:

• Toothpicks, used for centuries as oral hygiene tools and utensils, pose a risk of gastrointestinal injury.
• Ingestion is often unrecognized preoperatively due to lack of patient history and radiopacity of toothpicks.

Observation:

• This study presents five cases of gastrointestinal perforation caused by toothpick ingestion.
• Patients rarely report swallowing toothpicks, leading to delayed diagnosis.
• Complications included a duodenal-inferior vena caval fistula and recurrent sepsis.

Findings:

• Toothpick perforation of the gastrointestinal tract can lead to severe, life-threatening complications.
• Two of the five patients died from complications related to toothpick injury.
• Surgical intervention and endoscopic removal were employed in some cases.

Implications:

• Highlights the importance of considering toothpick ingestion in patients with unexplained gastrointestinal symptoms and perforation.
• Emphasizes the need for improved diagnostic awareness and timely management of toothpick-related injuries.
• Underscores the potential for severe morbidity and mortality associated with foreign body ingestion.