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  • Title: Duodenal perforation and right hydronephrosis due to toothpick ingestion.
    Author: Nigri GR, Di Giulio E, Di Nardo R, Pezzoli F, D'Angelo F, Aurello P, Ravaioli M, Ramacciato G.
    Journal: J Emerg Med; 2008 Jan; 34(1):55-7. PubMed ID: 17976746.
    Abstract:
    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.
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