Asymptomatic gastric perforation by a toothpick - A case report

Background: Many cases of gastric perforation with peritonitis, pylephlebit is, hepatic abscesses, or lethal bleeding, caused by ingested long and shar p objects, are reported in the literature. Methods: During a right hepatect omy for a giant hemangioma, a wooden toothpick was found between the two la yers of the hepatogastric ligament, It was not possible to find the passage of the foreign body through the gastric wall. The patient did not report a ny correlated symptoms. Results: There was no sign of inflammation around t he toothpick, which was enveloped in thin scar tissue. The removal of the f oreign body was performed without complications. Conclusions: The peculiari ty of our case is the total absence of symptoms during and after the perfor ation. Despite the benign evolution of our case, toothpicks must be conside red as potentially dangerous, like other pointed objects, and, therefore, r emoved immediately. Copyright (C) 1999 S. Karger AG, Basel.