Venkatasubramaniam, D Tennant, and SM Kelly International Journal of Surgery Case Reports. 10.1016/j.ijscr.2012.01.008
body ingestion is relatively common, toothbrush swallowing is rare. A
diagnosis of small-bowel perforation, caused by a sharp or pointed
foreign body, is rarely made preoperatively because the clinical
symptoms are usually nonspecific and can mimic other
surgical conditions, such as appendicitis and diverticulitis.
PRESENTATION OF CASE: We report a case of a swallowed toothbrush which
passed past the pylorus and perforated the terminal ileum. The patient
however presented with a fluctuant mass in the left iliac fossa, pyrexia
and generalised tenderness mimicking a diverticular abscess.
DISCUSSION: Ingestion of a foreign body is commonly encountered in the
clinic among children, adults with intellectual impairment, psychiatric
illness or alcoholism, and dental prosthetic-wearing elderly subjects.
However, toothbrush swallowing is rare, with only approximately 40
reported cases. CONCLUSION: Bowel perforation by foreign bodies can
mimic acute appendicitis and should be considered in differential
diagnoses. Clinically, patients often do not recall ingesting the
foreign body, which makes the clinical diagnosis more challenging, and a
correct diagnosis is frequently delayed. Several radiological
investigations, such as small- bowel series, ultrasonography, and
computed tomography scans, may lead to the correct diagnosis, but in
most patients, the diagnosis is not confirmed until the surgical
intervention has been performed. A Sewpaul, F Shaban, AK