Toothpick ingestion as a cause of acute and chronic duodenal inflammation

Toothpicks are a common cause of foreign body ingestion. We present two patients with duodenal inflammation secondary to toothpick ingestion. In the first patient, there was acute onset of severe abdominal pain, with findings on computed tomography consistent with marked duodenal inflammation. Endoscopy revealed a toothpick embedded in the wall of the duodenum with associated ulceration. In the second patient, 4 months of chronic abdominal pain was evaluated by upper endoscopy which revealed a toothpick embedded in a 1-cm ulcer found in the third portion of the duodenum. Both patients denied memory of ingestion of the toothpicks. Endoscopic removal of the toothpicks resulted in rapid relief of symptoms.