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Case Reports
. 2017 Dec 11;6(1):192-196.
doi: 10.1002/ccr3.1315. eCollection 2018 Jan.

Toothpick ingestion and migration into the liver through the colonic hepatic flexure: case presentation, management, and literature review

Affiliations
Case Reports

Toothpick ingestion and migration into the liver through the colonic hepatic flexure: case presentation, management, and literature review

Antoine El Asmar et al. Clin Case Rep. .

Abstract

The approach to toothpick ingestion and its complications should not be underestimated. The surgeon should be prepared for life-threatening situations such as major vascular involvement, as well as highly specialized and technically challenging procedures, when the hepatic hilum is involved for instance. Referral to tertiary centers is sometimes mandatory.

Keywords: Colonic perforation; surgical management; toothpick ingestion; toothpick migration into the liver.

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Figures

Figure 1
Figure 1
CT‐scan showing the abscess formation in segment V of the liver with an air bubble (thick white arrows) and fat stranding between the colonic hepatic flexure and the liver (thin white arrows).
Figure 2
Figure 2
CT‐scan showing the abscess (thick white arrows) with coronal cuts showing fat stranding communicating the colonic hepatic flexure all the way to the segment V of the liver reaching the abscess cavity (thin white arrows).
Figure 3
Figure 3
Hepatic wedge resection around the foreign object that revealed to be a toothpick (white arrows) protruding through liver segment V.
Figure 4
Figure 4
Hepatic specimen removed, with the toothpick lodged inside.

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