Toothpick impaction with sigmoid colon pseudodiverticulum formation successfully treated with colonoscopy

Abstract

Foreign bodies in the colon are encountered with increasing frequency, but only sporadic reports concerning their management have appeared in the literature. While most ingested foreign bodies usually pass through the gastrointestinal tract uneventfully, sharp foreign bodies such as toothpicks infrequently cause intestinal perforation and may even result in death. We report our experience with a patient with a sigmoid colon pseudodiverticulum formation, a complication of accidental ingestion of a toothpick that was diagnosed and successfully managed colonoscopically.

Figure 1

A: The endoscopic appearance of the toothpick in the sigmoid colon and removal of the toothpick was achieved using foreign-body extraction forceps. B: The endoscopic appearance of impacted colonic mucosa after removal of toothpick.

Figure 2

Initial abdominal CT shows severe wall thickening, pericolic fat infiltration and peritoneal thickening in the distal sigmoid colon. In the serosal surface, a small air-containing cavity lined by thin epithelium (arrow) is noted, which is consistent with a pseudodiverticulum.

Figure 3

Follow-up CT shows improvement of sigmoid colonic inflammation and disappearance of the pseudodiverticulum.