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Related Experiment Videos

Massive bleeding due to arterial-enteric fistula from an ingested toothpick.

B S Dicicco, H A Heit, J E Peterson

    Journal of Clinical Gastroenterology
    |August 1, 1985
    PubMed
    Summary

    A swallowed toothpick caused a rare arterial-enteric fistula, leading to severe lower gastrointestinal bleeding. Diagnosis was confirmed using vasopressin-enhanced arteriography, revealing the toothpick

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    Area of Science:

    • Gastroenterology
    • Vascular Surgery
    • Diagnostic Imaging

    Background:

    • Massive lower gastrointestinal bleeding necessitates prompt diagnosis and intervention.
    • Initial diagnostic attempts, including upper endoscopy and superior mesenteric arteriography, can be inconclusive.

    Observation:

    • A 62-year-old male presented with severe lower GI bleeding.
    • The bleeding source remained unidentified after initial endoscopic and angiographic evaluations.

    Findings:

    • Rebleeding prompted repeat arteriography with intra-arterial vasopressin infusion.
    • Vasopressin infusion facilitated visualization of an arterial-enteric fistula.
    • Exploratory laparotomy identified a toothpick perforating the small bowel and common iliac artery.

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    Implications:

    • This case highlights a rare cause of gastrointestinal hemorrhage.
    • Vasopressin-enhanced arteriography can be crucial for diagnosing obscure vascular lesions.
    • Foreign body ingestion, even seemingly innocuous items like toothpicks, can lead to life-threatening complications.