Chen T. Acute abdominal pain complicated by cecal perforation caused by an unnoticed swallowed toothpick: A case report. World J Gastrointest Surg 2025; 17(2): 102354 [DOI: 10.4240/wjgs.v17.i2.102354]
Corresponding Author of This Article
Tao Chen, MD, Department of Digestive Endoscopy Center, Digestive Disease Center, Suining Central Hospital, No. 127 Desheng West Road, Suining 629000, Sichuan Province, China. 1411706807@qq.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Gastrointest Surg. Feb 27, 2025; 17(2): 102354 Published online Feb 27, 2025. doi: 10.4240/wjgs.v17.i2.102354
Acute abdominal pain complicated by cecal perforation caused by an unnoticed swallowed toothpick: A case report
Tao Chen
Tao Chen, Department of Digestive Endoscopy Center, Digestive Disease Center, Suining Central Hospital, Suining 629000, Sichuan Province, China
Author contributions: Chen T contributed to manuscript writing and editing, and data collection; Chen T contributed to data analysis; Chen T contributed to conceptualization and supervision; Chen T has read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Tao Chen, MD, Department of Digestive Endoscopy Center, Digestive Disease Center, Suining Central Hospital, No. 127 Desheng West Road, Suining 629000, Sichuan Province, China. 1411706807@qq.com
Received: October 15, 2024 Revised: December 4, 2024 Accepted: December 16, 2024 Published online: February 27, 2025 Processing time: 98 Days and 22.6 Hours
Abstract
BACKGROUND
Acute abdominal pain is one of the most common gastrointestinal symptoms. The etiology of acute abdomen can be challenging for gastroenterologists to establish. Cecal foreign body is a rare cause of cecal perforation.
CASE SUMMARY
We report a 35-year-old male from China who initially exhibited symptoms suggestive of acute appendicitis. However, during a minimally invasive colonoscopy procedure, the authors found that a wooden toothpick caused the perforation. The patient presented to our emergency department with a 2 days history of right lower abdominal pain and low grade fever. The patient was in good health and had eaten fish 2 days earlier. Physical examination revealed mild pain with positive rebound tenderness in the right lower abdomen. However, computed tomography of the abdomen confirmed a strip of high-density shadows protruding beyond the intestinal cavity outline, with a small amount of peritoneal seepage in the ileocecal area. Combined with the medical history, the possibility of foreign body perforation by a fishbone and peripheral peritonitis were considered. However, the high-density shadow was identified as a wooden toothpick, which was removed via a minimally invasive procedure using a foreign body forceps under colonoscopy. The patient's condition improved significantly within 5 days after treatment.
CONCLUSION
We emphasize the importance of a detailed patient history, accurate diagnosis and proper treatment in patients with acute abdomen.
Core Tip: Foreign body ingestion is common in China, but it is rare to cause perforation of the caecum. In cases of complications such as intestinal perforation, particularly when foreign objects are unintentionally ingested, the diagnosis of the etiology of acute abdomen is quite challenging. Doctors should recognize the importance of computed tomography, as it is crucial for their diagnosis and subsequent treatment. After an object has been ingested, the recommended first-line treatment is to remove it endoscopically. Patients should receive appropriate intervention to prevent complications.
