Swallowed toothpick causes blood poisoning
A woman developed severe blood poisoning and a liver abscess after inadvertently swallowing a toothpick.
The toothpick perforated her gullet and lodged in a lobe of her liver.
The patient, who is not being identified, has now recovered after having the toothpick removed.
Such cases are rare, but the report, published by the British Medical Journal group, says doctors need to look out for signs of "foreign bodies", as detection can be challenging.
It is one of thousands of cases being logged at BMJ Case Reports, an online resource to allow doctors to share information about the treatment of difficult or unusual cases.
Swallowing foreign bodies is relatively common, particularly among children.
But the subsequent development of a liver abscess was rare, the authors, from Bristol's Frenchay Hospital and Dalhousie University in Halifax, Canada, said.
The condition has mostly been associated with inadvertently swallowing pins, nails, fish and chicken bones, rather than toothpicks.
But the authors said toothpicks could be "difficult to deal with effectively, because they don't show up on conventional X-rays and symptoms are often non-specific and remote".
In this particular case, the woman was admitted to hospital with generalised gut pain and fever, accompanied by nausea, vomiting, and low blood pressure.
An abdominal ultrasound scan revealed a liver abscess and the presence of a toothpick lodged in her liver. She subsequently developed breathing difficulties and an infection as a result of blood poisoning and had to be admitted to intensive care.
After treatment with antibiotics, she recovered and the toothpick was removed using keyhole surgery, after which all her symptoms cleared.
In another case on a similar theme in BMJ Case Reports, a surgical swab left inside the abdomen after surgery only came to light when the patient experienced persistent changes in her normal bowel habit.
The swab was clearly visible on a computerised tomography (CT) scan. Removal of the swab resolved her symptoms.