Toothpick injury mimicking acute cholecystitis

Research output: Contribution to journalArticlepeer-review


Introduction: Accidental foreign bodies ingestion is common in emergency department. However, if the objects are sharp, the complication rate is higher. Toothpick can cause severe complications of gastrointestinal tract due to being long, sharp ends on both sides, slender, and resistant to digestion. Case presentation: A 64-year-old man presented to the emergency department with fever and right upper abdominal pain for 3 days. The physical examination revealed severe pain with rebound tenderness in the right upper abdominal quadrant and positive Murphy’s sign. The provisional diagnosis of acute cholecystitis was made. The contrast abdominal-pelvic computed tomography scan revealed linear-shaped lesion penetrating hepatic flexure of colon and proximal transverse colon. The patient showed deterioration of vital sign, and therefore, emergency laparotomy was performed. Colon perforation by wooden toothpick was diagnosed. Discussion and conclusion: Toothpick ingestion without awareness is rare but fatal, especially when physicians failed to suspect foreign body ingestion. We think of this as one of the differential diagnoses, so we use contrast computed tomography scan.

Original languageEnglish
Pages (from-to)127-129
Number of pages3
JournalHong Kong Journal of Emergency Medicine
Issue number2
StatePublished - 1 Mar 2019

Bibliographical note

Publisher Copyright:
© The Author(s) 2018.


  • Foreign body ingestion
  • intestinal perforation
  • toothpick


Dive into the research topics of 'Toothpick injury mimicking acute cholecystitis'. Together they form a unique fingerprint.

Cite this