Duodenal perforation and right hydronephrosis due to toothpick ingestion.
We report a case of a 36-year-old man who was admitted to the Emergency Department with right flank pain. The clinical presentation was suggestive of renal colic. However, a computed tomography scan showed the presence of a foreign body in the inferior duodenal flexure. Upper gastrointestinal endoscopy demonstrated a 6.5-cm wooden toothpick deeply embedded in the duodenal wall; this was removed via endoscopy. The peri-duodenal inflammatory reaction had encased the right ureter, resulting in hydronephrosis. The patient did well and was discharged on post-operative day 7. He did not recall toothpick ingestion. When evaluating patients with acute abdominal pain, foreign body ingestion should be considered. In patients with a history of toothpick ingestion, immediate diagnosis with endoscopic management should be performed.
Nigri
Giuseppe R
GR
Department of Surgery, La Sapienza University of Rome, II School of Medicine, Rome, Italy.
Di Giulio
Emilio
E
Di Nardo
Raffaella
R
Pezzoli
Francesca
F
D'Angelo
Francesco
F
Aurello
Paolo
P
Ravaioli
Matteo
M
Ramacciato
Giovanni
G
D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D004378:Duodenal Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D004435:Eating; D005547:Foreign Bodies; D005548:Foreign-Body Migration / Q000150:complications* / Q000000981:diagnostic imaging; D006801:Humans; D006869:Hydronephrosis / Q000209:etiology*; D007416:Intestinal Perforation / Q000000981:diagnostic imaging / Q000209:etiology*; D008297:Male; D011859:Radiography