Toothpick impaction in a sigmoid diverticulum

BMJ Case Reports
Shanesh KumarAntony Cass

Abstract

A 70-year-old woman presented to our emergency department with recurrent episodes of left lower quadrant pain. She subsequently underwent high anterior resection with working diagnosis of acute diverticulitis, but intraoperatively was found to have perforated sigmoid diverticulum due to toothpick impaction. A high index of suspicion is required for diagnosis of toothpick ingestion. Appropriate preoperative investigations such as endoscopy and CT, despite their fairly low sensitivity, should be performed to increase the ability to accurately diagnose this condition and therefore optimise subsequent management.

References

Oct 28, 1999·Gastrointestinal Endoscopy·S K ReddyN H Stollman
Nov 27, 2001·Internal Medicine Journal·A WettsteinE Warren
Sep 10, 2002·The Journal of Emergency Medicine·Siu Fai Li, Kimberly Ender
Jul 26, 2013·Clinical Medicine Insights. Case Reports·Robert J SealockDavid Y Graham
Jan 15, 2015·World Journal of Emergency Surgery : WJES·Andrea LoveceLuigi Bonavina

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Citations

Oct 17, 2017·Clinical Journal of Gastroenterology·Ellen RossJohn H Anderson

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