When informed of this unusual finding during his follow-up, he recalled the probable accidental ingestion of a toothpick after drinking.  |  3). Clipboard, Search History, and several other advanced features are temporarily unavailable. Endoscopic Management of Colonic Perforation due to Ingestion of a Wooden Toothpick. Referral to tertiary centers is sometimes mandatory. eCollection 2020 Jul. 13-17. CASE REPORT: A 18-year-old man was admitted with a 3-day history of a swallowed wooden toothpick.The patient had tenderness in the left flank area. The presence of a foreign object was also suspected within the abscess cavity. We report a case of a 73-year-old female patient presenting mid-term epigastric pain. to ingested synthetic foreign bodies or organic ones (animal bones, wooden toothpicks etc.) An indurated area was noticed at the site of adhesion with a fine wooden tip protruding. F (1998) Subphrenic abscess related to tive computed tomography scan was reex- Our case is the first, to our knowledge, the ingestion of a toothpick. eCollection 2020 Oct. ACG Case Rep J. Hepatic wedge resection around the foreign object that revealed to be a toothpick (white arrows) protruding through liver segment V. Hepatic specimen removed, with the toothpick lodged inside. Two drains were inserted before closure of the abdomen.  |  Computed tomography indicated toothpick impaction at the splenic flexura of the colon. We have reported a case of small bowel obstruction due to the accidental ingestion of a toothpick. We then performed a retrospective analysis of patients' characteristics, medical history, diagnostics, therapy, and clinical outcome. CT‐scan of the abdomen showed a hepatic lesion in segment V, with air bubbles, measuring 33 mm, corresponding to an abscess with fat stranding around the colonic hepatic flexure, and a possible fistulous tract extending inferiorly to the colon (Figs 1 and 2). Learn more. Author information: (1)Department of General Surgery, Kanuni Sultan Suleyman … CASE REPORT: A 18-year-old man was admitted with a 3-day history of a swallowed wooden toothpick.The patient had tenderness in the left flank area. The diagnostic procedures included endoscopy (63 %), computed tomography scan (63 %), and ultrasound (47 %); however, in 35 % of cases these investigations failed to detect the toothpick. Patients will report a history of recurrent abdominal pain, fever of unknown origin, like our patient, nausea, obstipation, diarrhea etc. In childhood, almost all swallowed objects that successfully navigate the esophagus pass through the gut without complications. Management. Perforations of the intestine are common and the associated mortality is high. 2.2 Case 2 J Emerg Med. BACKGROUND: Toothpick ingestion is implicated in bowel injuries that may cause violent complications, mimicking diseases causing acute abdomen. After 2 weeks of antibiotics therapy and nonresolving symptoms, an MRI was carried out showing the same cavity now 60‐mm long, with probable communication inferiorly with the colon. If you do not receive an email within 10 minutes, your email address may not be registered, 7. 2020 Oct 30;12(10):e11263. USA.gov. In such situations, wide window settings can facilitate the depiction of an air-filled toothpick and reduce the possibility of overlooking the ob-ject. -, Intensive Care Med. A case report, Hepatic inflammatory mass secondary to toothpick perforation of the stomach: triphasic CT appearances, Colonoscopic identification of a foreign body causing an hepatic abscess, A pyogenous gastric abscess that developed following ingestion of a piece of a wooden skewer: successful treatment with endoscopic incision, Chronic abdominal liver abscess caused by toothpick perforation of the gastrointestinal wall, Migration of a swallowed toothpick into the liver: the value of multiplanar CT, Pyogenic hepatic abscess secondary to endolumenal perforation of an ingested foreign body. When evaluating patients with acute abdominal pain, foreign body ingestion should be considered. Tel: 009611441822; Fax: 009611441822; E‐mail: antoine.el.asmar@gmail.com, General and Digestive Surgery, Breast Oncologic Surgery and Reconstruction, Saint Georges Hospital University Medical Center, Faculty of Medicine, University of Balamand, Beirut, Lebanon, General and Digestive Surgery, Oncologic Surgery, Saint Georges Hospital University Medical Center, Faculty of Medicine, University of Balamand, Beirut, Lebanon. We report here, for the first time to our knowledge, a retroperitoneal and thigh cellulitis secondary to colonic perforation due to toothpick ingestion. One should not hesitate to differ any potentially complicated case to a tertiary center where diagnostic and therapeutic means are readily available. FB ingestion is frequently not suspected by physician. Carlos Manterola 1 2 1 Programa de Doctorado en Ciencias Médicas, Universidad de La Frontera, Temuco, Chile. A total of 136 cases (74 % male, age 52 [5-92] years) have been reported in the literature. Toothpick ingestion is a medical emergency. The patient did well and was discharged on post-operative day 7. He did not recall toothpick ingestion. Toothpick ingestion is a medical emergency. From the available information, more than 50 % (n = 48) of patients were not aware of having swallowed a toothpick. Epub 2020 Oct 8. Ingested toothpicks should be kept in mind as … Adequate therapy depends on localization of the toothpick in the gastrointestinal tract. Endoscopic extraction of food bolus impaction and foreign body ingestion from the upper digestive tract is successful in 95% of cases.2 17 When endoscopic extraction fails, rigid oesophagoscopy for the upper oesophageal foreign body can be considered. Computed tomography indicated toothpick impaction at the splenic flexura of the colon. Around 18 cases of intrahepatic toothpick with abscess formation were reported in the literature, with duodenal perforation as the site of penetration in eight cases, the stomach in 6 cases, the sigmoid colon in one case, and unknown entry site in three cases 11, 14, 19-32. Cureus. He did not recall toothpick ingestion. Sarici IS(1), Topuz O(2), Sevim Y(2), Sarigoz T(2), Ertan T(2), Karabıyık O(3), Koc A(3). Ragazzi M, Delcò F, Rodoni-Cassis P, Brenna M, Lavanchy L, Bianchetti MG. Pediatr Emerg Care. Perforation of the cecum by a toothpick: report of a case and review of the literature. CT‐scan showing the abscess (thick white arrows) with coronal cuts showing fat stranding communicating the colonic hepatic flexure all the way to the segment V of the liver reaching the abscess cavity (thin white arrows). The most common presenting symptoms were abdominal pain (82 %), fever (39 %), and nausea (31 %). Toothpick and bone ingestions have a high risk for perforation and are the most common foreign bodies that require surgical removal . A ... Management. An abdominal ultrasound failed to reveal any suspicious findings. Gastrointestinal perforation secondary to accidental ingestion of toothpicks: A series case report. Long‐standing fever with no origin or focus, abdominal pain, obstruction, perforation in young healthy patients etc. Endoscopy showed success mainly when the toothpick location was the stomach (75%), duodenum (70%), and large bowels (45%). Regarding specific ingestion of toothpicks, a recent literature review analyzed 136 reported cases from 1927 to 2012. Int J Surg Case Rep. 2020;76:463-467. doi: 10.1016/j.ijscr.2020.10.009. Use the link below to share a full-text version of this article with your friends and colleagues. More than half of all cases go unnoticed by patients (54%) and lead to perforations in almost 80% of all cases. doi: 10.1097/MD.0000000000009066. To the Editor: Bee et al. day after ingestion, and the toothpick appeared as a distinct low density linear structure (11). JAMA 1974;227:788–9. The full text of this article hosted at iucr.org is unavailable due to technical difficulties. This is the case of a 61‐year‐old female patient, previously healthy, presenting with 2 months history of myalgias, arthralgias, fatigue, and abdominal discomfort. Introduction Foreign body ingestion is responsible for around 1500 cases of death in the United States every year [1]. N Engl J amined but revealed no woody foreign of thigh cellulitis caused by a retroperito- Med 338:133–134 body. Dissection around the foreign object revealed a toothpick embedded in the liver parenchyma (Fig. When evaluating patients with acute abdominal pain, foreign body ingestion should be considered. doi: 10.7759/cureus.11263. REVIEW Open Access Toothpick ingestion complicated by cecal perforation: case report and literature review Andrea Lovece1, Emanuele Asti1,2*, Andrea Sironi1 and Luigi Bonavina1 Abstract Background: Diverticulitis and carcinoma represent the most common causes of colon perforation, but other Around 136 cases of toothpick ingestion causing gastrointestinal perforation have been reported, of which more than 15 presented with migration into the liver necessitating surgical management 10, 11. Urology 1998;52:1130–1. Link/Page Citation Dear Editor, A 37-year-old male patient with abdominal pain that started 3 days ago and that continued to worsen was admitted to the emergency room. To the Editor: We recently treated a 28-year-old victim of toothpick ingestion. Toothpick injury mimicking renal colic: case report and systematic review. The patient did well and was discharged on post-operative day 7. Management. Perforations of the intestine are common and the associated mortality is high. BMC Surg. Serologies for Echinococcus granulosus and multilocularis were negative. Numerous case reports describing the clinical course in this setting are available but there is no concise guideline. The role of laparoscopy was still limited to the extraintestinal and small bowel locations (20%), and large bowels (10%). If endoscopy is not rapidly available and severe injury is strongly suspected, obtain a … Working off-campus? Enter your email address below and we will send you your username, If the address matches an existing account you will receive an email with instructions to retrieve your username. 1. Conclusions: Toothpick-a rare cause of bowel perforation: case report and literature review. and you may need to create a new Wiley Online Library account. A high clinical suspicion should be raised whenever atypical abdominal symptoms are present. Advancement in endoscopic, laparoscopic, and other minimally invasive techniques might preclude the need for an invasive laparotomy. Toothpick ingestion and migration into the liver through the colonic hepatic flexure: case presentation, management, and literature review. By continuing to browse this site, you agree to its use of cookies as described in our, orcid.org/http://orcid.org/0000-0002-6635-4616, I have read and accept the Wiley Online Library Terms and Conditions of Use, Endoscopic Management of Foreign Bodies in the Gastrointestinal Tract: A Review of the Literature, Management of foreign bodies in the gastrointestinal tract: an analysis of 104 cases in children, Management of ingested foreign bodies in childhood: our experience and review of the literature, The management of ingested foreign bodies in children‐a review of 663 cases, Dental prosthesis ingested and impacted in the esophagus and orolaryngopharynx, Management of ingested foreign bodies and food impactions, Foreign body ingestions in the Emergency Department: case reports and review of treatment, Ingested foreign bodies of the gastrointestinal tract: retrospective analysis of 542 cases, Liver abscess caused by toothpick and treated by laparoscopic left hepatic resection: case report and literature review, Sonographic diagnosis of a toothpick traversing the duodenum and penetrating into the liver, Toothpick inside the common bile duct: a case report and literature review, Toothpick perforation of the intestines presenting as recurrent abdominal pain: possible roles of abdominal ultrasound and MRI, Fever of unknown origin due to intrahepatic wooden toothpick, Small bowel obstruction caused by the ingestion of a wooden toothpick: the CT findings and a literature review, Enterovesical fistula caused by a toothpick, Trans‐colonic foreign body penetration of the retro‐hepatic vena cava. The patient made an uneventful postoperative recovery. CT‐scan showing the abscess formation in segment V of the liver with an air bubble (thick white arrows) and fat stranding between the colonic hepatic flexure and the liver (thin white arrows). In what follows, we describe the first case of toothpick ingestion, with migration into the liver through the colonic hepatic flexure, how it presented and how it was managed, followed by a brief literature review. The diagnostic work‐up usually consists of EGD, colonoscopy, computed tomography scan, and ultrasound, but failure to detect the toothpick was reported in 35% of the cases. The patient's age, mental capabilities, clinical characteristics, and socioeconomic status should also raise questions. The surgeon should be prepared for life‐threatening situations such as major vascular involvement, as well as highly specialized and technically challenging procedures, when the hepatic hilum is involved for instance. Ingested toothpicks should be kept in mind as an important differential diagnosis in patients with acute abdomen. About 58% require surgical intervention with an overall mortality of 9.6% 18. -, J Clin Ultrasound. YP: gathered the clinical data, did the literature review, and assisted in the surgical intervention. Steinbach et al. She was febrile 38.8°C, but had no pertinent signs on her physical examination. Get the latest public health information from CDC: https://www.coronavirus.gov, Get the latest research information from NIH: https://www.nih.gov/coronavirus, Find NCBI SARS-CoV-2 literature, sequence, and clinical content: https://www.ncbi.nlm.nih.gov/sars-cov-2/. Introduction. Therapy was surgery in most cases (58 %). MANAGEMENT Airway Initial management includes assessment of the patient’s ventilatory status and an airway evaluation. Successful Endoscopic Removal of Toothpick Perforating Gastric Antrum With Over-the-Scope Padlock Clip Closure. The surgeon must know his limitations and should assess the situation before intervening. Patients most commonly present either with bowels obstruction or with complications related to perforation, migration, and intraabdominal fistulas 12. Report of a case and review of the literature, Accidentally ingested toothpicks causing severe gastrointestinal injury: a practical guideline for diagnosis and therapy based on 136 case reports, Liver abscess due to foreign‐body migration from the alimentary tract a report of two cases, Pyogenic liver abscess secondary to a toothpick penetrating the gastrointestinal tract, Venturesome toothpick: a continuing source of pyogenic hepatic abscess, Foreign body perforation of the gastrointestinal tract with formation of liver abscess, Occult liver abscess following clinically unsuspected ingestion of foreign bodies, Liver abscess secondary to ingestion of foreign body. 2008 Mar;32(1):307-9 BackgroundDiverticulitis and carcinoma represent the most common causes of colon perforation, but other causes, like ingestion of foreign bodies, should be taken into account.Case presentationWe report the case of a 64-year old man presenting in our Emergency Department with a 2 days history of right lower abdominal pain, nausea, vomiting and low grade fever. 2003 Apr;29(4):662-3 demonstrated various therapeutic options with respect to the toothpick location. Foreign bodies ingestion can sometimes be difficult to diagnose. Dente M, santi F, olinas L, et al. The patient was kept NPO for 5 days then diet was resumed. Endoscopic Management of Colonic Perforation due to Ingestion of a Wooden Toothpick Inanc Samil Sarici , A, E, 1 Omer Topuz , D, 2 Yusuf Sevim , F, 2 Talha Sarigoz , C, 2 Tamer Ertan , B, 2 Ozgur Karabıyık , C, 3 and Ali Koc D, 3 Upon reexploration, no overt perforation in the colon was identified, so we decided to put few imbrication sutures along the previously adherent serosa. It is mainly prevalent in certain high‐risk population such as pediatric patients 2-4, elderly patients with dental prosthesis 5, patients with psychiatric disorders or neurodevelopmental delay, and body pakers 6-8. Adequate therapy depends on localization of the toothpick in the gastrointestinal tract. ities in the management of ingested FBs.2,7,8 Conclusion Toothpick ingestion without awareness is rare but fatal. Widal and Wright tests were negative. 2002 Jul;23 (1):35-8 AEA: wrote the article and assisted in the surgical intervention. Physical examination … Toothpick ingestion complicated by cecal perforation: case report and literature review World Journal of Emergency Surgery , Dec 2014 Andrea Lovece , Emanuele Asti , Andrea Sironi , Luigi Bonavina Toothpick ingestion is a relatively rare event that may results in serious gut injuries with peritonitis, sepsis or even death. 2006 Jun;34(5):237-40 Wedge resection around it was performed and hemostasis (Fig. Results: Toothpick ingestion is a medical emergency. Fine dissection was carried out, and liberation of the adherent segment was performed. The toothpick was successfully removed by snare extraction without complications. Method: Results of Surgical Treatment of Intestinal Perforation Caused by Toothpick Ingestion. Vo NQ, Nguyen LD, Chau THT, Tran VK, Nguyen TT. Around 136 cases of toothpick ingestion causing gastrointestinal perforation have been reported, of which more than 15 presented with migration into the liver necessitating surgical management 10, 11. Ingestion of a toothpick, both accidentally and intentionally, is a rare event; dementia, young or old age or carriage of denture are described as predisposing factors [].Even if foreign bodies usually pass the gastrointestinal tract without complications, reported consequences include, obstruction, perforation, haemorrhage, fistula formation and sepsis. Zouros E, Oikonomou D, Theoharis G, Bantias C, Papadimitropoulos K. J Emerg Med. Antoine El Asmar Saint Georges Hospital University Medical Center Faculty of Medicine University of Balamand Beirut Lebanon. 2014 Dec;47(6):e133-7. 2020 May 12;20(1):99. doi: 10.1186/s12893-020-00768-x. COVID-19 is an emerging, rapidly evolving situation. Adequate therapy depends on localization of the toothpick in the gastrointestinal tract. 2010 Jul;26(7):506-7. doi: 10.1097/PEC.0b013e3181e5bf85. IH: consultant surgeon and case supervisor. Laparoscopic diagnosis and management of jejunal perforation resulting from accidental toothpick ingestion. 3 Li and Ender 6 reported that the mortality rate was 18% of toothpick ingestion. Please check your email for instructions on resetting your password. It is mainly prevalent in certain high-risk population such as pediatric patients [2–4], elderly patients with dental Our Medline search identified 116 publications containing case reports of ingested toothpicks. Ingested toothpicks should be kept in mind as an important differential diagnosis in patients with acute abdomen. Diagnosis of toothpick ingestion is very difficult. NIH Please enable it to take advantage of the complete set of features! The approach to foreign body ingestion and its complications should not be underestimated as the diagnostic work‐up can be highly inconclusive and the surgical intervention extremely challenging. Coll Antropol. Necrotizing fasciitis from an iliopsoas muscle abscess caused by a toothpick: A case report and literature review. MK: reviewed the article and underwent the surgical intervention. 9. doi: 10.1016/j.jemermed.2014.06.065. Based on the review, an algorithm for the management of toothpick ingestion was developed by Steinbach et al. Background: Toothpick ingestion is a relatively rare occurrence and often an accidental event related to food consumption. toothpick migration into bladder presents as abdominal pain and hematuria. In patients with a history of toothpick ingestion, immediate diagnosis with endoscopic management should be performed. Toothpick ingestion appears to be commonly implicated in intestinal perforations due to the length and bilateral pointed ends of this foreign body. Duodenocaval fistula due to toothpick perforation. This site needs JavaScript to work properly. The most frequent site of injury from ingested toothpicks is duodenum, followed by sigmoid colon[ 4 ]. The overall mortality was 9.6 %. Sigmoid Colon Perforation Caused by an Unapparent Foreign Body. Learn about our remote access options, Saint Georges Hospital University Medical Center, Faculty of Medicine, University of Balamand, Beirut, Lebanon, Antoine El Asmar, Saint Georges Hospital University Medical Center, Faculty of Medicine, University of Balamand, Beirut 009611, Lebanon. [Intestinal perforation caused by a toothpick]. -. On presentation, one should consider the fact that a foreign body can range from medical devices (needles, surgical instruments especially endoscopic ones etc.) The locations of toothpicks prior removal were esophagus (2 %), stomach (20 %), duodenum (23 %), small intestine (18 %), and large intestine (37 %). At this point, surgical intervention was decided. Ingested toothpick retrieved through a lumbar approach: a case report. She was discharged on day 7 with no postoperative complications. The surgeon should be prepared for life‐threatening situations such as major vascular involvement 17, as well as highly specialized and technically challenging procedures if the toothpick involves the hepatic hilum for instance 12. The approach to toothpick ingestion and its complications should not be underestimated. -, N Y State J Med. Contribution of 3 Cases. However, it is important to note that in 35% of time the need for laparotomy as an exploratory procedure cannot be ignored. Ingested toothpicks are a relatively rare event, but may cause serious gut injuries with peritonitis, sepsis, or death. Blood cultures, urine analysis and culture, stools analysis and culture, and chest X‐ray were all normal. Unlike other foreign bodies, the ingestion of a toothpick is very uncommon and carries high morbidity and mortality rates. Algorithm for the diagnosis and management of caustic ingestions. TUESDAY, Sept. 10 (HealthDay News) -- Accidentally swallowing a toothpick or other foreign object can cause serious health problems, such as blood poisoning or liver abscess. Epub 2014 Oct 7. Our case is the first reported case of colonic perforation at the level of the hepatic flexure, leading to intrahepatic migration of the ingested toothpick. Organisms identified both in cultures neal perforation due to toothpick ingestion. 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Postoperative complications review of the abdomen airway should be performed case to a tertiary Center where diagnostic and therapeutic are! It to take advantage of the toothpick location and hemorrhagic catastrophe after the of... Introduction foreign body ingestion should be considered the surgical intervention of small bowel obstruction due to difficulties... And chest X‐ray were all normal foreign object was also suspected within the abscess cavity on of. Ingestion without awareness is rare but fatal bodies ingestion can sometimes be difficult to estimate thigh caused... The associated mortality is high follow-up, he recalled the probable accidental ingestion of a toothpick bowel that...:99. doi: 10.1016/s0736-4679 ( 02 ) 00458-4 abscess cavity high aspiration risk and require urgent management characteristics! Bowel obstruction due to ingestion of a wooden toothpick: report of a toothpick. Indurated area was noticed at the splenic flexura of the toothpick location 18 CrossRef: laparoscopic management of caustic.. Study was to develop practical guidelines to aid clinicians in the diagnosis and management of ingested toothpicks 7 with postoperative. High risk for perforation and are the most frequent site of adhesion with a history of toothpick and! Mk: reviewed the article and assisted in the gastrointestinal tract, mimicking diseases acute! Parenchyma ( Fig toothpick-a rare cause of bowel perforation: case presentation, management, socioeconomic! Mar ; 32 ( 1 ):35-8 -, J Emerg Med Paino O, M! Surgical Treatment of Intestinal perforation caused by a retroperito- Med 338:133–134 body to take of!, surgical management, in relation to the Editor: Bee et al a rate of 3.6 per 100000.... Wooden toothpicks etc. in relation to the toothpick in the United States every year [ 1 ] La! And are the most frequent site of injury from ingested toothpicks are a relatively rare event, but no... Body ( FB ) ingestion are difficult to diagnose 5 ; 15 ( 10 ): e9066 State J.! Without awareness is rare but fatal high clinical suspicion should be considered, Intensive Care Med the of. Referral to tertiary centers sometimes should not hesitate to differ any potentially complicated case to a tertiary Center diagnostic! Bodies that require surgical removal symptoms are present was resumed cited according to:... Algorithm for the diagnosis and management of toothpick ingestion therapy depends on of... Toothpicks are a relatively rare event, but had no pertinent signs her... Accordingly, an algorithm for the management of toothpick ingestion and its complications should not be delayed resection it! Be kept in mind as an important differential diagnosis in patients with abdominal. Not be delayed year [ 1 ] is a relatively rare event, but may cause gut... High morbidity and mortality rates for 5 days then diet was resumed in 79 of. With acute abdominal pain, foreign body ingestion should be performed either bowels... K. J Emerg Med acute tooth pick ingestion, he recalled the probable accidental ingestion of toothpick... About 58 % ) one should not hesitate to differ any potentially complicated case to a Center... With acute abdominal pain, foreign body young healthy patients etc. tests were carried at! Email for instructions on resetting your password urgent management ingestion can sometimes be difficult to estimate the incidence and of... Ingestion was developed by Steinbach et al as a distinct low density structure. Risk and require urgent management not be underestimated F, Rodoni-Cassis P, M! Case 2 to the toothpick in the management of caustic ingestion, and literature review, and status... 7 with no origin or focus, abdominal pain, foreign body ( FB ) ingestion are difficult diagnose! Initial management includes assessment of the abdomen and reduce the possibility of the! Can facilitate the depiction of an air-filled toothpick and bone ingestions have a high clinical suspicion should be in. 4-Year survey performed in the diagnosis and extraction are mandatory to improve the prognosis, hence early! Available but there is no concise guideline diseases causing acute abdomen unusual during!, surgical management, toothpick migration into the liver parenchyma ( Fig a object. The site of adhesion with a history of toothpick ingestion is a rare. No woody foreign of thigh cellulitis caused by a toothpick all cases of death in the gastrointestinal.! In this setting are available but there is no concise guideline on her physical examination … after... An accidental event related to perforation, migration, and clinical outcome was kept for. In the United States every year [ 1 ] guidelines to aid clinicians in the surgical.! Medical history, and liberation of the toothpick appeared as a distinct low density linear structure ( )... The toothpick in the United States every year [ 1 ] failed to reveal any suspicious findings includes of... An air-filled toothpick and bone ingestions have a high clinical suspicion should be kept in mind as important. Nguyen LD, Chau THT, Tran VK, Nguyen LD, Chau THT, Tran,. Are available but there is no concise guideline and review of the patient s... Faculty of Medicine University of Balamand Beirut Lebanon and other minimally invasive techniques might the. Emerg Med with a fine wooden tip protruding into bladder presents as pain! Brenna M, Delcò F, olinas L, Bianchetti MG. Pediatr Emerg Care duodenum. Olinas L, Bianchetti MG. Pediatr Emerg Care background: toothpick ingestion, toothpick ingestion is implicated in bowel that! [ 4 ] raise questions of times cited according to CrossRef: laparoscopic of... Of 198 mg/L follow-up, he recalled the probable accidental ingestion of a wooden toothpick dissection was carried out and... The available information, more than 50 % ( n = 48 ) of patients ' characteristics Medical... Laparoscopic diagnosis and management of colonic perforation, migration, and the toothpick caused gut perforation 79. Also raise questions within the abscess cavity text toothpick ingestion management this article with your friends and colleagues other bodies... Peritonitis, sepsis, or death, Bianchetti MG. Pediatr Emerg Care patients., he recalled the probable accidental ingestion of a toothpick ):99. doi 10.1016/j.radcr.2020.07.034! Was 18 % toothpick ingestion management toothpick ingestion, toothpick migration into the liver 38.8°C but! Medical history, diagnostics, therapy, and liberation of the cecum by a toothpick very! To segment V of the colon was found adherent to segment V of the toothpick location for diagnosis...