Endoscopic Removal of a Toothpick Impacted in the Stomach Wall by Mucosal Incision

Han, Jee Young; Bang, Byoung Wook; Kim, Hyung Gil; Kwon, Kye Sook; Shin, Yong Woon

doi:2012.12.4.276

Korean J Helicobacter Up Gastrointest Res > Volume 12(4); 2012 > Article

Case Report

The Korean Journal of Helicobacter and Upper Gastrointestinal Research 2012;12(4):276-279.
DOI: https://doi.org/10.7704/kjhugr.2012.12.4.276 Published online December 10, 2012.

Endoscopic Removal of a Toothpick Impacted in the Stomach Wall by Mucosal Incision

Jee Young Han, Byoung Wook Bang, Hyung Gil Kim, Kye Sook Kwon, Yong Woon Shin

Division of Gastroenterology, Department of Internal Medicine, Inha University School of Medicine, Incheon, Korea. bangbu@inha.ac.kr

Abstract

Toothpicks are not uncommonly swallowed, and subsequently, may be impacted into gastrointestinal wall and cause morbidities, and even mortality. Therefore, the early diagnosis and immediate retrieval of an ingested toothpick is important. In many cases, endoscopic removal is attempted initially, but if this fails or a complication is encountered, surgery should be considered. The authors experienced a case of ingested toothpick penetrating the gastric wall. A 51-year-old woman visited our hospital with epigastric pain of one-week duration. Upper endoscopy revealed that the sharp end of a toothpick had been impacted into the distal antrum. Endoscopic removal using an alligator jaw forceps failed because the toothpick broke during removal and our continued attempts to extract the remnant resulted in it becoming more embedded in the stomach wall. In such circumstances, surgical treatment should be considered. However, we incised the mucosa to expose the remnant toothpick, and fortunately, we were then able to grasp and remove the toothpick using an alligator jaw forceps. We report this unusual case of a toothpick impacted in the gastric wall that was resolved endoscopically by mucosal incision.

Key Words: Foreign bodies; Endoscopy