Citation

Lai CMS, Lui TH. BMJ Case Rep. 2018; 2018(ePub): ePub.

Affiliation

Orthopaedics and Traumatology, North District Hospital, Hong Kong, Hong Kong.

Copyright

(Copyright © 2018, BMJ Publishing Group)

DOI

10.1136/bcr-2018-225258

PMID

30002212

Abstract

Toothpick ingestion is a rare but potentially fatal condition which may cause bowel perforation and rare complications if it migrates out of the gastrointestinal tract. This case report describes a delayed presentation of toothpick-induced small bowel injury leading to abdominal wall abscess and spondylodiscitis. A 51-year-old man was admitted twice with fever and loin pain, but repeated non-contrast CT was reported to be unremarkable. However, 5 months later, he presented with a left lower quadrant abdominal wall abscess and back pain. An updated CT showed a linear hyperdensity which was already present in previous scans, causing small bowel perforation, abdominal wall abscess and spondylodiscitis. Emergency laparotomy identified a toothpick causing small bowel perforation. The abdominal wall abscess was incised and drained, and small bowel was repaired.

© BMJ Publishing Group Limited 2018. No commercial re-use. See rights and permissions. Published by BMJ.

Language: en

Keywords

foreign bodies; gastrointestinal surgery; intestinal perforation; radiology