A case of penetration of the small intestinal wall by a toothpick

Abstract

A 59-year-old man complaining of right hypochondralgia was admitted to our hospital with a suspicion of diverticulitis. Temporary improvement was gained by using antibiotics, however, restarting diet exacerbated this symptom. Therefore exploratory laparotomy was performed. There was an intraperitoneal inflammatory tumor involving a part of the jejunum and transverse colon. The resection of the tumor with partial jejunectomy and transverse colectomy was performed. Abscess formation was noted inside of the tumor and in the tumor, a toothpick was found penetrating from the jejunum. Penetration of the small intestinal wall by the toothpick was diagnosed.
Penetration of the digestive tract by a toothpick is rare and sometimes it becomes difficult to diagnose unless we know the history of accidental ingestion. Penetration of a foreign body should be considered as one of the causes for acute abdomen of unknown origin.