Gastric perforation due to the ingestion of a hollow toothpick: report of a case.
A perforation due to the ingestion of a toothpick is a condition seldom seen in the stomach. We herein describe an 80-year-old woman with a perforation of the stomach due to an ingested hollow toothpick. The toothpick was easily removed during a mini-laparotomy. The site of perforation was closed with absorbable sutures and omentum was used to function as an overlying patch. The postoperative course was uncomplicated. The hollow toothpick functioned as a fistula between the contents of the stomach and the peritoneal cavity. This resulted in a very different clinical picture from that observed in "classical wooden" toothpick injury, where the toothpick is not able to function as a fistula. To the best of our knowledge, this is the first description of a hollow toothpick perforating the stomach. A hollow toothpick perforation must be considered in any patient with symptoms of intestinal perforation, even when there is no history of swallowing toothpicks. Removal of a toothpick and subsequent suturing of the puncture site is a simple and relatively minor surgical procedure, which may have a lower morbidity and mortality as compared to other causes of gastric perforation. A precaution to observe, is the potential danger that one of the members of the operating team might perforate a finger.
Department of Surgery, Spaarne Hospital, Haarlem, The Netherlands.
Pascal
P
Steenvoorde
Chantal M
CM
Moues
Jaap H
JH
Viersma
D000006:Abdomen, Acute / Q000209:etiology*; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005547:Foreign Bodies / Q000000981:diagnostic imaging; D006801:Humans; D011859:Radiography; D013270:Stomach / Q000000981:diagnostic imaging / Q000293:injuries*