Sigmoid colon perforation caused by ingested toothpick

Case contributed by Ayaz Hidayatov
Diagnosis certain


A middle aged male presented with abdominal pain, fever, and nausea for a week.

Patient Data

Age: 40
Gender: Male

CT demonstrates linear hyperdense foreign body (4 cm) impacted in the sigmoid colon and piercing the colonic wall. There is pericolic fat stranding, inflammatory changes and a 46x42 mm rounded collection (abscess) adjacent to the sigmoid colon.

Abdominal open surgery revealed a wooden toothpick causing perforation of the sigmoid colon.

Case Discussion

Ingested foreign body causing bowel perforation is rare. This case emphasizes the uncommon but possibly severe hazards associated with the ingestion of toothpicks. Such sharp objects may cause acute inflammation with or without obvious perforation and present with signs of an acute abdomen.

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