Unusual duodenal perforation due to ingested toothpick. A case report

Accidental foreign body ingestion is a common reason for consultation, primarily affecting the pediatric population and, less frequently, elderly individuals. Toothpicks are commonly used not only for oral hygiene but also as decorations, eating utensils, and in food preparation. This variety of uses has contributed to an increase in accidental ingestion, especially in settings such as catering services, family dinners, and weddings. Early diagnosis and prompt retrieval of ingested toothpicks causing gastrointestinal perforation are crucial for reducing potentially life-threatening consequences. We present a case of intestinal perforation caused by accidental toothpick ingestion in a 63-year-old male, treated at the University Hospital Center of Batna. The patient presented with acute left flank pain and nausea. Physical examination showed abdominal tenderness, while laboratory tests were normal. An abdominal CT scan revealed a double-pointed toothpick perforating the 4th portion of the duodenum near the renal artery. The patient underwent an urgent laparotomy, during which the toothpick was successfully removed. The postoperative course was uneventful.