Successful endoscopic retrieval of an accidentally ingested toothbrush in a 95-year-old male : a clinical case report

Accidental foreign body ingestion in the paediatric age group is a common presentation to the Emergency department, with most objects being small and round. Accidental ingestion of non-organic, long, and rigid foreign bodies in adults is relatively rare, and is usually seen in patients with an underlying psychiatric illness. Such foreign bodies are unlikely to pass through the entirety of the gastrointestinal tract owing to their length and rigidity, and are therefore associated with the risk of pressure ulcers, necrosis, and perforation, which necessitates their prompt removal. We report the case of a 95-year-old male with Parkinson’s disease, who presented to the Emergency Department with alleged history of having swallowed his toothbrush an hour prior to arrival. The patient was hemodynamically stable. An X-ray of the abdomen confirmed the presence of the toothbrush with the radio-opaque bristle end seen in the left upper quadrant. The Gastroenterologist was involved, and an endoscopic retrieval of the toothbrush was planned immediately. There were challenges encountered in the endoscopic removal owing to the smooth surface of the toothbrush. However, successful retrieval was accomplished, and patient was discharged the following day with no complications. Accidental ingestion of toothbrush in adults is extremely rare. Owing to its length and structure, the tooth brush is unlikely to be naturally expelled from the rectum, and therefore associated with risk of complications like perforation, which necessitates prompt removal.