Successful Endoscopic Removal of Toothpick Perforating Gastric Antrum With Over-the-Scope Padlock Clip Closure

Our unique case demonstrates the use of an over-the-scope Padlock clip for closure of a sharp foreign body induced gastric perforation, avoiding the need for surgical intervention. A 47-year old female presented with a two-day history of abdominal pain with nausea. Abdominal CT scan revealed a linear density in the distal body of the stomach extending outside the lumen. Endoscopic evaluation revealed a toothpick perforating through the wall of the gastric antrum. Endoscopic removal was performed, and closure of the full-thickness defect was achieved with an over-the-scope Padlock clip. The patient subsequently made an uneventful recovery, with no reported complications at two-year follow-up. Early endoscopic removal and closure of gastric luminal perforations by over-the-scope Padlock clips are viable alternative treatments for defects previously considered only amenable to surgical repair. Endoscopic treatment of gastrointestinal perforations has shown to decrease the morbidity and mortality associated with more invasive surgical procedures.