Gastroenterology, Yangzhou University/Northern Jiangsu People's Hospital Affiliated to Yangzhou University, China.
Gastroenterology, Yangzhou University/Northern Jiangsu People's Hospital Affiliated to Yangzhou University.
Rev Esp Enferm Dig. 2024 May;116(5):285-286. doi: 10.17235/reed.2023.9898/2023.
Toothpick ingestion is an uncommon condition. It has been reported that an estimated incidence of 3.6 toothpick related injuries per 100,000 people per year. However, the incidence of toothpick-related gastrointestinal tract perforation is as high as 80%, with small bowel perforation accounting for 18% of cases. Common symptoms associated with toothpick ingestion include abdominal pain, fever, nausea, diarrhea, and constipation. However, it may lead to peritonitis, abscesses, and sepsis in severe cases. The diagnosis of toothpick ingestion is difficult. Only a minority (12%) of patients remember eating toothpicks and the sensitivity of computed tomography (CT) and endoscopy is 43% and 70%, respectively. When a toothpick penetrates the small intestine or is accompanied by other adverse events such as peritonitis, the vast majority of patients undergo surgery. Double-balloon enteroscopy (DBE) is not only an examination method for small intestinal diseases, but also an endoscopic treatment for the removal of sharp foreign bodies such as toothpicks. We report an elderly woman who was diagnosed as toothpick penetrated the jejunal wall and successfully retrieval under DBE. To our best knowledge, there is currently only one report of removing toothpick from the small intestine using DBE. We figured that DBE is a feasible, safe, and effective treatment when toothpicks penetrate the small intestinal wall without other adverse events based on our presentation.
牙签摄入是一种不常见的情况。据报道，每年每 10 万人中有 3.6 例与牙签相关的损伤。然而，牙签相关的胃肠道穿孔的发生率高达 80%，其中小肠穿孔占 18%。与牙签摄入相关的常见症状包括腹痛、发热、恶心、腹泻和便秘。但在严重的情况下，可能会导致腹膜炎、脓肿和败血症。牙签摄入的诊断很困难。只有少数（12%）的患者记得吃了牙签，计算机断层扫描（CT）和内窥镜的敏感度分别为 43%和 70%。当牙签穿透小肠或伴有腹膜炎等其他不良事件时，绝大多数患者需要手术治疗。双气囊小肠镜（DBE）不仅是一种小肠疾病的检查方法，也是一种内镜治疗方法，可用于取出牙签等尖锐异物。我们报告了一例老年女性患者，诊断为牙签穿透空肠壁，在 DBE 下成功取出。据我们所知，目前只有一篇关于使用 DBE 从小肠中取出牙签的报道。我们认为，在没有其他不良事件的情况下，当牙签穿透小肠壁时，DBE 是一种可行、安全和有效的治疗方法。
