Abstract
Toothpick ingestion is implicated in gut injuries which may cause severe complications, mimicking diseases causing acute abdomen. However, toothpick ingestion-related perforation may also cause mild, non-specific gastrointestinal symptoms without significant findings or major complications. We describe a young male with chronic postprandial lower abdominal pain caused by a toothpick impaction at the rectosigmoid junction after inadvertent ingestion. The foreign body was detected and successfully removed during flexible sigmoidoscopy. Perforation due to foreign body ingestion must be considered in the differential diagnosis in patients presenting with unexplained symptoms and findings, even when they do not recall any foreign body ingestion.
Highlights
Foreign body (FB) ingestion is a common problem in everyday emergency clinical practice
We describe a young male with chronic postprandial lower abdominal pain caused by a toothpick impaction at the rectosigmoid junction after inadvertent ingestion
Perforation due to foreign body ingestion must be considered in the differential diagnosis in patients presenting with unexplained symptoms and findings, even when they do not recall any foreign body ingestion
Summary
Foreign body (FB) ingestion is a common problem in everyday emergency clinical practice. He suffered from postprandial abdominal pain and urgency for defecation He sought for medical help at the emergency department of a city general hospital, but due to the negative results of the examinations, the symptoms were attributed to irritable bowel syndrome. Abdominal and pelvic computed tomography (CT) scan was performed subsequently and revealed severe segmental wall thickening, sparse diverticulas, pericolic fat infiltration and peritoneal thickening at the sigmoid colon region (Figure 1). A regular diet was instituted gradually during the few days and intravenous antibiotics were switched to oral During this period, the patient noted a complete remission of his postprandial abdominal pain and urgency for defecation. Abdominal and pelvic CT scan showed a dramatic improvement of the findings with decrease of sigmoid colon wall thickening and resolution of pericolic fat infiltration and peritoneal thickening (Figure 4). Colonic biopsies from the rectum and the sigmoid colon revealed mild chronic non-specific inflammatory reaction, without specific findings of Crohn’s or any other form of colitis
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