Endoscopic Management of Colonic Perforation due to Ingestion of a Wooden Toothpick

Patient: Male, 18 Final Diagnosis: Perforation Symptoms: Abdominal pain Medication: — Clinical Procedure: Endoscopy Specialty: Surgery OBJECTIVE: Rare disease BACKGROUND: Toothpick ingestion is implicated in bowel injuries that may cause violent complications, mimicking diseases causing acute abdomen. CASE REPORT: A 18-year-old man was admitted with a 3-day history of a swallowed wooden toothpick. The patient had tenderness in the left flank area. Computed tomography indicated toothpick impaction at the splenic flexura of the colon. It was successfully removed with colonoscopy. After the procedure, abdominal radiography showed free air as a sign of perforation. Along with conservative management, the patient was discharged without surgery. CONCLUSIONS: There is need for greater awareness of the hazardous of an ingested toothpick. Endoscopic approach should be considered in the first-line management of toothpick perforations.