title: Toothpick ingestion causing duodenal perforation.
abstract: In childhood, almost all swallowed objects that successfully navigate the esophagus pass through the gut without complications. In a 15-year-old male adolescent with the initial working diagnosis of acalculous cholecystitis, computed tomography revealed a thickened wall of the second duodenal portion, some infiltration of the periduodenal tissue, and a hyperdense needle-shape structure probably passing through the duodenal wall. Endoscopy revealed a wooden toothpick perforating the duodenum that was carefully retracted. An uneventful recovery followed the endoscopic removal of the foreign body. A computer-based search of the literature to examine the injuries caused by ingested toothpicks since 1960 found only 4 reports in 5 children.
authors.affiliation: Division of Pediatrics, Ospedale Mendrisio, Mendrisio, Switzerland.
authors.forename: Monica
authors.initials: M
authors.lastname: Ragazzi
authors.forename: Fabiola
authors.initials: F
authors.lastname: Delcò
authors.forename: Paola
authors.initials: P
authors.lastname: Rodoni-Cassis
authors.forename: Massimo
authors.initials: M
authors.lastname: Brenna
authors.forename: Laure
authors.initials: L
authors.lastname: Lavanchy
authors.forename: Mario G
authors.initials: MG
authors.lastname: Bianchetti
mesh_terms: D015746:Abdominal Pain / Q000209:etiology; D000293:Adolescent; D004386:Duodenum / Q000000981:diagnostic imaging; D004724:Endoscopy; D005547:Foreign Bodies / Q000150:complications* / Q000000981:diagnostic imaging / Q000601:surgery; D006801:Humans; D007416:Intestinal Perforation / Q000000981:diagnostic imaging / Q000209:etiology*; D008297:Male; D012008:Recurrence; D014057:Tomography, X-Ray Computed