A healthy young athlete came dangerously close to death when he accidentally swallowed a rather commonplace item: a toothpick.
The apparently mundane toothpick wreaked mayhem within the 18-year-old man’s body, where the item pierced the wall of his lower intestine and poked into an artery, according to a new report of the case, revealed Wednesday (Jan. 30) in the New England Journal of medicine.
The injuries would eventually lead to severe hemorrhage together with a bloodstream infection. However, the man did not remember swallowing the toothpick, and it took weeks and visits to 3 hospitals before doctors discovered what was behind his mysterious symptoms, the report said.
The young athlete, whose identity was withheld by the report authors, had been healthy when he left on a trip to the southeastern U.S.
It was while on this trip that he began to feel abdominal pain, nausea, diarrhea and fever. This conditions prompted him to visit the doctors and a CT scan and some tests were run. The doctors couldn’t find anything wrong with him so he left and went back to his hotel after 5 hours.
Symptoms would disappear in the following weeks, but the abdominal pain returned when he took another trip. This time, he also experienced back pain and bloody stools, which prompted another visit to the ER. A scan imaging revealed air and fluid in his large intestine. While the ER doctors weren’t certain of the cause of the young man’s symptoms, they advised that he visits another doctor when he gets back to his home in New England.
There, doctors at the Massachusetts General Hospital in Boston suggested a colonoscopy. The procedure revealed a 2-inch (5 centimeters) toothpick poking into the wall of the man’s large intestine.
The doctors were surprised”to find the toothpick, since they hadn’t seen it on imaging scans and the man hadn’t reported that he swallowed anything unusual, Dr. Fabian J. Scheid, an internist at Mass General who treated the patient, told The New York Times.
Doctors removed the toothpick with the help of an endoscope, a long, flexible tube with a camera attached. But the toothpick had also injured an artery, and once the object was removed, the man experienced “life-threatening” bleeding, the report said. He was rushed to the operating room, where he needed extensive surgery to repair the damage and stop the bleeding.
By now you are aware of the serious risks of injury posed by toothpicks. A 2014 review carried out by doctors from Germany showed 136 cases of people who swallowed toothpicks, finding that 80 percent of those patients experienced a puncture in their gut from the toothpick and nearly 10 percent died from their injuries.
This kind of severity is still rare. “It is rare for someone to get this kind of complication, to this degree, with toothpick ingestion,” said Dr. Jefry Biehler, chairman of pediatrics at Nicklaus Children’s Hospital in Miami, who was not involved in the New England case. Often, toothpicks can be removed without surgery, but it’s still important for adults, or parents of children, to seek medical care if they or their children have swallowed a toothpick, Biehler said.
The real danger results when a person doesn’t realize they’ve swallowed a toothpick, as such it can be difficult to diagnose. Wood toothpicks are often very difficult to see on imaging tests like X-rays or even ultrasounds, Biehler said in an interview with Live Science.
The current case highlights the need for doctors “to keep an open mind” and to consider a broad range of diagnoses for someone who has abdominal pain without a clear cause, Biehler told Live Science. It also shows that “anything that can go into a mouth, somebody’s going to swallow,” he said. Little children in particular will swallow pretty much anything, and they should not be allowed to have toothpicks in their mouths, he said.
After being told about the toothpick, the young man from New England, though he didn’t recall swallowing a toothpick, he remembered eating a sandwich which he said didn’t go down so well right before the symptoms started, The New York Times reported.
7 months after his life threatening ordeal, the young athlete returned to professional sport. This was after treating a blood infection, and having to undergo months of rehab and fitness training.
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