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Inanc Samil Sarici, Omer Topuz, Yusuf Sevim, Talha Sarigoz, Tamer Ertan, Ozgur Karabıyık, Ali Koc
(Department of General Surgery, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey)
Am J Case Rep 2017; 18:72-75
Toothpick ingestion is implicated in bowel injuries that may cause violent complications, mimicking diseases causing acute abdomen.
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. Computed tomography indicated toothpick impaction at the splenic flexura of the colon. It was successfully removed with colonoscopy. After the procedure, abdominal radiography showed free air as a sign of perforation. Along with conservative management, the patient was discharged without surgery.
CONCLUSIONS: There is need for greater awareness of the hazardous of an ingested toothpick. Endoscopic approach should be considered in the first-line management of toothpick perforations.