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In a very rare case, a female in Canada was found to need minimally invasive hepatic resection because she ingested a toothpick. The toothpick moved from the gastrointestinal tract towards the liver causing its damage. A laparoscopy confirmed that the toothpick resulted in a liver abscess. More about this case appeared online on Sept. 10 in the BMJ Case Reports journal.

A team of doctors, from the Dalhousie University's Department of Surgery in Nova Scotia, Canada, was handling that case. They said that the patient is a 45-year-old woman that was sent to the emergency room with epigastric pain along with a fever of almost 39°C, in addition to nausea, vomiting and hypotension.

Using abdominal sonography, doctors found a liver abscess and a foreign object, which later was identified as a toothpick 4.1 cm in length with a width of few millimeters; it was lodged inside the liver.

As the condition of the patient worsened she began experiencing respiratory difficulties and systemic infection due to blood poisoning from the toothpick. She was moved to an intensive care unit and was given extensive antibiotics for a number of weeks.

A contrast CT scan of the abdomen revealed the foreign object and doctors chose laparoscopic cholecystectomy as the best solution. After removing the toothpick, the patient’s health was successfully restored and at 6 months she continued to do well.

The doctors reported that while liver abscess caused by foreign body ingestion was common, lesions caused by toothpicks were very rare. They indicated that only 17 cases have been recorded since 1955.

The team reported "To the best of our knowledge, this is the first case of a patient who had an intra-operative ultrasound and laparoscopic hepatic resection for a hepatic toothpick causing sepsis and multiorgan failure,"