Successful Endoscopic Removal of a Toothpick Penetrating the Sigmoid Colon：A Case Report

Abstract

A 70-year-old male visited another hospital due to abdominal pain persisting for 1 month. Abdominal computed tomography (CT) revealed a linear high-attenuation structure (5cm) protruding from the lumen through the wall of the sigmoid colon. He was diagnosed as having colon penetration by a foreign body, and was referred to our hospital. There was only mild lower left abdominal tenderness. Blood tests showed no increase in inflammatory markers. Therefore, emergency surgery was considered unnecessary. Colonoscopy revealed a toothpick with both ends piercing the wall of the sigmoid colon. The toothpick was removed using grasping forceps. His subsequent course was favorable, and he was discharged on hospital day 3. He was unaware that he had accidentally ingested a toothpick. In Japan, gastrointestinal perforation/penetration by a fish bone has often been reported, but colorectal perforation/penetration by an accidentally ingested toothpick has been relatively rare. In addition, there have been only 4 reported patients who underwent colonoscopic removal of a toothpick. We report this patient along with a brief review of the literature.