Sun Zhenlin, Lu Minmin, Ding Xiaorui, Xue Chunxia
Emergency Department, Binzhou People's Hospital, Binzhou, Shandong, China.
Department of Gastroenterology, Binzhou People's Hospital, Binzhou, Shandong, China.
Front Surg. 2025 Sep 2;12:1610269. doi: 10.3389/fsurg.2025.1610269. eCollection 2025.
Ingestion of foreign bodies, particularly sharp objects like toothpicks, can lead to severe gastrointestinal complications. This case report describes a rare instance of a superior mesenteric artery (SMA)-duodenal fistula with subsequent SMA thrombosis caused by a toothpick.
A 47-year-old woman presented with persistent upper abdominal pain. Abdominal CT revealed increased density around the pancreatic neck. Further CT reconstruction identified a linear foreign body in the duodenum, which was confirmed as a toothpick during surgery. The toothpick had perforated the duodenum and pancreas. Postoperatively, the patient developed lower abdominal pain, melena, and declining hemoglobin levels. Enhanced CT indicated SMA thrombosis. Despite attempts to recanalize the SMA, conservative management was pursued due to good collateral circulation. The patient recovered well and was discharged after stabilization.
This case highlights the potential for toothpick ingestion to cause rare and severe complications, including fistula formation and arterial thrombosis. Clinicians should be vigilant about foreign body ingestion in cases of unexplained abdominal pain and consider comprehensive management strategies to prevent catastrophic outcomes.
吞食异物，尤其是像牙签这样的尖锐物体，可能导致严重的胃肠道并发症。本病例报告描述了一例罕见的由牙签导致的肠系膜上动脉（SMA）-十二指肠瘘并继发SMA血栓形成的病例。
一名47岁女性因持续性上腹部疼痛就诊。腹部CT显示胰颈周围密度增加。进一步的CT重建在十二指肠发现一个线性异物，手术中证实为牙签。该牙签已穿透十二指肠和胰腺。术后，患者出现下腹部疼痛、黑便和血红蛋白水平下降。增强CT显示SMA血栓形成。尽管尝试对SMA进行再通，但由于侧支循环良好，仍采取了保守治疗。患者恢复良好，病情稳定后出院。
本病例突出了吞食牙签导致罕见且严重并发症的可能性，包括瘘管形成和动脉血栓形成。临床医生在遇到不明原因腹痛的异物吞食病例时应保持警惕，并考虑采取综合管理策略以防止灾难性后果。
