Lai Carol Man Sze, Lui Tun Hing
Department of Surgery, Prince of Wales Hospital, Hong Kong.
Orthopaedics and Traumatology, North District Hospital, Hong Kong, Hong Kong.
BMJ Case Rep. 2018 Jul 11;2018:bcr-2018-225258. doi: 10.1136/bcr-2018-225258.
Toothpick ingestion is a rare but potentially fatal condition which may cause bowel perforation and rare complications if it migrates out of the gastrointestinal tract. This case report describes a delayed presentation of toothpick-induced small bowel injury leading to abdominal wall abscess and spondylodiscitis. A 51-year-old man was admitted twice with fever and loin pain, but repeated non-contrast CT was reported to be unremarkable. However, 5 months later, he presented with a left lower quadrant abdominal wall abscess and back pain. An updated CT showed a linear hyperdensity which was already present in previous scans, causing small bowel perforation, abdominal wall abscess and spondylodiscitis. Emergency laparotomy identified a toothpick causing small bowel perforation. The abdominal wall abscess was incised and drained, and small bowel was repaired.
牙签吞食是一种罕见但可能致命的情况，如果牙签移出胃肠道，可能会导致肠穿孔和罕见的并发症。本病例报告描述了一例因牙签导致的小肠损伤延迟出现，进而引发腹壁脓肿和脊椎椎间盘炎的情况。一名51岁男性因发热和腰痛两次入院，但多次非增强CT检查均报告无异常。然而，5个月后，他出现了左下腹腹壁脓肿和背痛。一次更新的CT显示出一条先前扫描中就已存在的线性高密度影，该影导致了小肠穿孔、腹壁脓肿和脊椎椎间盘炎。急诊剖腹手术发现一根牙签导致小肠穿孔。切开并引流腹壁脓肿，修补小肠。
