Unusual Differential Diagnosis of Upper Abdominal Pain. (22nd January 2008)

• Record Type: Journal Article
• Authors: Monika, Lanthaler; Thomas, Grissmann; Lukas, Schwentner; Hermann, Nehoda
• Other Names: Herron Daniel M. Academic Editor.
• Is Part Of: Diagnostic and therapeutic endoscopy. Volume 2009(2009)
• Publication Date: 2008-01-22
• Subjects: Endoscopy -- Periodicals; Endoscopie; Endoscopy; Endoscopy -- Periodicals; Electronic journals; Periodicals; 616.07545
• DOI: 10.1155/2009/817052
• Languages: English
• ISSNs: 1070-3608

Abstract

Abstract : We here present an interesting unusual case of upper abdominal pain. The patient was a 38-year-old man, who was admitted to our hospital complaining of right upper quadrant pain caused by a toothpick that perforated the anterior gastric wall and penetrated segment I of the liver. After endoscopic removal and an initially uneventful course, computed tomography revealed a perigastric abscess that was treated by repeated gastroscopic rinsing via an endoscopically placed catheter. After another three uneventful weeks, a liver abscess with minor tendency to constrict the portal vein was diagnosed, and a segment I liver resection together with abscess drainage was performed. The peculiarity of this case is the rarity of toothpick ingestion and gastric perforation in a young and healthy white Caucasian followed by development of a liver abscess after primary uneventful endoscopic removal. In light of this case, gastric perforation due to ingested foreign bodies such as toothpicks can be considered a rare cause of upper abdominal pain.