title: Bacteremia caused by a swallowed toothpick impacted in the gastric mucosa.
abstract: Although most ingested foreign bodies usually pass through the gastrointestinal tract asymptomatically, toothpick injury to the gastrointestinal tract is often associated with significant morbidity and mortality. Toothpick perforation of the gastrointestinal tract is frequently reported but, to the best of our knowledge, bacteremia caused by an impacted toothpick within the gastric mucosa has not yet been described. Here, we report the case of bacteremia caused by an accidentally swallowed toothpick. The toothpick was impacted deeply in the gastric mucosa and was first seen and localized on contrast-enhanced computed tomography (CT). CT scan is a very useful imaging technique in such situations since we lack typical and relevant physical findings or laboratory studies that go with accidentally swallowed objects, in this case a toothpick. Flexible endoscopy was successful in extracting the whole toothpick. In cases without free perforation, flexible endoscopy is the treatment of choice in toothpick removal from the upper gastrointestinal tract.
authors.affiliation: Department of Internal Medicine, Division of Gastroenterology, University Hospital Split, Split, Croatia.
authors.forename: Ante
authors.initials: A
authors.lastname: Tonkic
authors.forename: Drago
authors.initials: D
authors.lastname: Kulic
authors.forename: Mari
authors.initials: M
authors.lastname: Peric
authors.forename: Marija
authors.initials: M
authors.lastname: Tonkic
authors.forename: Zoran
authors.initials: Z
authors.lastname: Bogdanovic