Quy initially underwent an ultrasound at a clinic, which showed no abnormalities. However, when his pain intensified, he sought examination at Tam Anh General Hospital TP HCM. A subsequent CT scan of his abdomen revealed a linear, hyperdense structure, approximately 22 mm in size, located in the terminal ileum (the final section of the small intestine), having perforated the intestinal wall.

Doctor Nguyen Thi Thuy Truc, from the Diagnostic Imaging and Interventional Radiology Center, explained that the small size of the foreign object made it challenging to detect via ultrasound. The intestinal loops contained gas, there was no abdominal fluid, and no clear inflammatory reaction around the object, further limiting visibility.

An abdominal CT scan revealed the foreign object piercing Quy's small intestine wall. Photo: Tam Anh General Hospital

Doctor Ngo Hoang Kien Tam, from the Endoscopy and Gastrointestinal Laparoscopic Surgery Center, stated that the foreign object had completely penetrated the intestinal wall, creating a perforation communicating with the abdominal cavity. The patient required surgery to remove the object and prevent the high risk of generalized peritonitis.

Following a consultation, an emergency laparoscopic surgical team observed a small amount of cloudy fluid between the small intestinal loops and in the right iliac fossa. A segment of the ileum, approximately 50 cm long, was inflamed and red. The team successfully removed a toothpick, about 2,5 cm long, which had pierced the wall of a Meckel's diverticulum. Surgeons then resected the Meckel's diverticulum using an automatic stapler. A thorough examination of the entire small intestine, large intestine, and stomach revealed no other abnormalities.

Doctor Tam (far right) performing laparoscopic surgery to remove the foreign object from Quy. Photo: Tam Anh General Hospital

Post-surgery, Quy's abdominal pain subsided. He was able to sit up, walk, and eat porridge after one day, and was discharged after 5 days.

Doctor Tam noted that swallowing foreign objects is a common accident, most often involving fish bones, chicken bones, toothpicks, or other small sharp items. While most foreign objects can pass through the digestive tract and be naturally excreted, long, sharp, or double-pointed objects risk becoming lodged, causing perforation of the digestive tract or damage to other organs.

The small intestine contains digestive fluids, partially digested food, and a large number of bacteria. When the intestinal wall is perforated, these fluids can leak into the abdominal cavity, leading to peritonitis or abdominal abscesses. Sharp foreign objects can also continue to migrate within the abdomen, damaging adjacent organs or major blood vessels, causing complications.

To prevent such incidents, doctors advise against holding toothpicks in the mouth after eating, especially while talking, working, or resting. When consuming foods with bones, thorough and careful chewing is essential. If experiencing prolonged or worsening abdominal pain, fever, nausea, vomiting, or digestive disturbances, and suspecting a swallowed foreign object, individuals should seek early medical attention to avoid complications.

Quyen Phan - Nhu Ngoc

*Patient's name has been changed