CASE 491: TOOTHPICK MOVING TO RETROPERITONEUM, Dr PHAN THANH HẢI, MEDIC MEDICAL CENTER, HCMC, VIETNAM

Man 60 yo with  epigastric pain  one month ago; in  emergency CT of abdomen detected    a  foreign body ( FB) looked like a toothpick penetrating duodenum D2 wall.

But gastroscopy and colonoscopy cannot find  out this foreign body (FB). And  so  do laparoscopy later.

At Medic center,  ultrasound again detected this foreign body (FB) in retroperitoneum  near IVC and aorta (US 1. US 2), very strong shadowing , US 3: longitudinal  FB # 5 cm).

MSCT of abdomen  non CE   (CT1:  crossed section  this FB near aorta , CT 2 : frontal view , CT 3:  3 D view).

Gastroscopic laparoscopy again removed this  toothpick # 5 cm at the wall of D2.

Conclusion : Toothpick  can move to retroperitoneum.
REFERENCES:

In10 years at Medic it exists  5 published cases about toothpick , CASE  20 dec 2008  dr LY PHAI ,   MEDIC ULTRASOUND CASE 232,  CASE 229,  CASE 479 , CASE  491 and 7 other cases.

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