Anterior abdominal wall abscess due to toothpick ingestion: A case report

Abstract

Ingestion of foreign bodies represents a common clinical emergency, especially in pediatric and geriatric populations. In the majority of cases, ingested foreign objects pass through the gastrointestinal tract without incident and are expelled without causing symptoms. However, complications can arise depending on the size, shape, and structure of the ingested item. A 53-year-old male with a history of diabetes, hypertension, chronic obstructive pulmonary disease, and obesity was admitted to the hospital due to recurrent subcutaneous abscesses and cellulitis in the right upper quadrant of the anterior abdominal wall. The patient's medical history reveals several times of abscess puncture in the same area. The patient underwent subcutaneous abscess drainage under local anesthesia, and toothpick material fixed to the subcutaneous tissues was detected. Following the removal of the toothpick, debridement of the wound was performed, and the patient was discharged with antibiotherapy. No recurrence was noted during the follow-up outpatient clinic visit three months later. This case report highlights the rare and complex complication of subcutaneous migration following foreign body ingestion, leading to recurrent subcutaneous abscesses. The exact pathogenesis of foreign body migration is not fully understood, but it is probable that the toothpick penetrates the subcutaneous fatty tissue from the transverse colon segment near the anterior abdominal wall, leading to the spontaneous closure of the colonic fistula tract. The foreign body was detected in radiological imaging in approximately 42.6 % of cases. A high level of clinical suspicion and a thorough patient history are essential for the identification of radiolucent foreign bodies.