Strangely enough, the patient swallowed a toothpick and punctured the stomach for 2 months without detecting it.

20/10/2023 13:29

Expected of a stomachache, a 48-year-old female patient treated herself at home. After 2 weeks of self-treatment with the gastritis medicines did not improve, the patient was admitted to the hospital and surprised when the doctor found that the culprit was a toothpick that penetrated the pyloric wall and stabbed into her left liver.

That is the case of Mrs. C.L.H, 48 years old, resides in Hanoi. The patient has a healthy history and a habit of flossing with a bamboo toothpick after every meal. Mrs. H said that she had pain that appeared 2 months ago, a dull pain in the epigastric area, sometimes cramping, accompanied by a lot of pain and difficulty breathing so she self-treated with medicine for gastritis at home then after 2 weeks without improving, she went to a general hospital for health check, the endoscopic examination only showed a mass protruding into the stomach, CT scan did not detect any abnormalities, then she was transferred to the Central Geriatric Hospital for x-rays suspecting a foreign object penetrating the pyloric wall and penetrating the left liver then transferred to Viet Duc University Hospital.

Specialist II degree. Nguyen Dac Thao, MD – Colorectal & Perineal Surgery Center, Viet Duc University Hospital said: when admitting to the hospital, patient C.L.H was alert, no fever, soft abdomen, pain in the epigastric and left lower quadrant, no tenderness, no vomiting, normal defecation. CT scan showed 2 foreign objects: 1 foreign object 22mm long penetrating the pylorus wall and 1 foreign object 21mm long under the left liver. The endoscopic examination showed inflammatory infiltrates in the duodenal bulb, bleeding easily, negative pressure suction showed no pus or foreign bodies.

After 1 week of antibiotic treatment, the patient’s abdominal pain remained, and the CT scan of the foreign object was still in the same position, she was indicated for laparoscopic surgery to remove the foreign object. Checking through the operation, the abdominal cavity was clean, no fluid, the upper surface of the pylorus was attached to the lower surface of the left liver with a lot of inflammatory infiltration. After removing the adherence, 3 pieces of foreign objects that looked like broken bamboo toothpicks were found, penetrating from the pylorus up to the liver. The surgeons have removed the foreign object, carefully examined the pylorus, however, they did not see a clear perforation, so a drain was placed for monitoring. After removing the specimen from the abdominal cavity, it looked very similar to a bamboo toothpick.

Dr. Thao said, this is a daily accident that occurs in all ages, especially in people who have the habit of holding toothpicks after eating. Foreign bodies can be found in any part of the digestive tract from the mouth, esophagus, stomach, small intestine, colon and anus. Foreign objects are usually animal bones (chicken bones, duck bones, fish bones…), or even pieces of meat; foreign objects in daily life (bamboo toothpicks, nails, screws, coins…). This daily life accident is very dangerous if not detected and treated promptly, causing perforated internal organs, bleeding, oropharyngeal abscess, mediastinal abscess, intra-abdominal abscess, pelvic abscess, and infection. infections, affecting the patient’s quality of life, and in many cases can lead to death.

When suffering from a foreign object, the patient needs to be diagnosed promptly and properly and immediately transferred to reputable facilities for examination, removal of the foreign object, and treatment of combined injuries: esophageal perforation, stomach perforation. thickened, perforated intestines.