Laparoscopic Treatment of Right Colic Flexure Perforation by an Ingested Wooden Toothpick

INTRODUCTION: Ingestion of a toothpick, both accidentally and intentionally, is a rare event. PRESENTATION OF CASE: We present the case of a 42-years old man who was admitted to the emergency department at our Institution presenting with a 5-days history of right sided abdominal pain. Laboratory blood count reported leukocytosis and alteration of principal inflammation index; at the abdominal ultrasound no signs of perforation or collection were described. DISCUSSION: Indication to surgery was posed and an explorative laparoscopy was performed. The presence of local peritonitis at the right colonic flexure secondary to a full thickness bowel perforation caused by a toothpick was found. There was also an acute phlegmonous appendicitis. A laparoscopic appendectomy and a full-thickness double running suture of the perforation were performed. CONCLUSION: Awareness about dangers of ingested toothpicks needs to be taken and the intestinal track/trace of the toothpick is mandatory until its expulsion. (C) 2020 Published by Elsevier Ltd on behalf of IJS Publishing Group Ltd.