{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T17:22:44Z","timestamp":1787937764012,"version":"build-2784847793"},"reference-count":7,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:00:00Z","timestamp":1787875200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T00:00:00Z","timestamp":1787875200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["DEN Open"],"published-print":{"date-parts":[[2027,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>Ingested toothpicks can perforate the gastrointestinal tract and penetrate adjacent organs. Pancreatic involvement is rare, and its management varies between surgical and endoscopic interventions. We report the successful endoscopic removal of a toothpick that penetrated the gastric wall and extended into the head of the pancreas. A 59\u2010year\u2010old man presented with a 5\u2010day history of fever and epigastric pain. Laboratory tests revealed inflammatory changes, with normal serum amylase and hemoglobin levels. Non\u2010contrast computed tomography (CT) with multiplanar reconstruction (MPR) revealed a linear, slightly hyperattenuating foreign body measuring at least 5 cm, extending from the posterior wall of the lower body of the stomach to the head of the pancreas, with minimal free air, surrounding fat stranding, and no dilation of the main pancreatic duct. Contrast\u2010enhanced CT revealed no major vascular involvement or active extravasation. Esophagogastroduodenoscopy was performed on hospital day 3 with surgical backup. A wooden foreign body protruding from the gastric mucosa was removed with biopsy forceps through an overtube under conscious sedation. The extracted object was a 6.5\u2010cm wooden toothpick. The post\u2010procedural course was uneventful. This case highlights the value of MPR and contrast\u2010enhanced CT in defining a foreign body's trajectory and determining procedural feasibility. Endoscopic removal may be a safe and minimally invasive alternative to surgery in selected cases of pancreatic penetration.<\/jats:p>","DOI":"10.1002\/deo2.70418","type":"journal-article","created":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T17:15:31Z","timestamp":1787937331000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Endoscopic Removal of a Toothpick Penetrating the Gastric Wall and Extending Into the Head of the Pancreas: A Case Report and Brief Literature Review"],"prefix":"10.1002","volume":"7","author":[{"given":"Ken","family":"Nakayama","sequence":"first","affiliation":[{"name":"Department of Surgery Ibaraki Western Medical Center Ibaraki Japan"},{"name":"Department of Gastrointestinal and Hepatobiliary\u2013Pancreatic Surgery Faculty of Medicine University of Tsukuba Ibaraki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takanori","family":"Ueda","sequence":"additional","affiliation":[{"name":"Department of Surgery Ibaraki Western Medical Center Ibaraki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noriyuki","family":"Isohata","sequence":"additional","affiliation":[{"name":"Department of Surgery Ibaraki Western Medical Center Ibaraki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tadashi","family":"Kondo","sequence":"additional","affiliation":[{"name":"Department of Surgery Ibaraki Western Medical Center Ibaraki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuji","family":"Hiraoka","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Ibaraki Western Medical Center Ibaraki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshihiro","family":"Tanabe","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine Ibaraki Western Medical Center Ibaraki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hironobu","family":"Yamazaki","sequence":"additional","affiliation":[{"name":"Department of Surgery Jichi Medical University Saitama Medical Center  Saitama Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keiichiro","family":"Yoshikata","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology Nippon Medical School Graduate School of Medicine Tokyo Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masayoshi","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Department of Surgery Ibaraki Western Medical Center Ibaraki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tatsuya","family":"Oda","sequence":"additional","affiliation":[{"name":"Department of Gastrointestinal and Hepatobiliary\u2013Pancreatic Surgery University Hospital of Tsukuba Ibaraki Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,28]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.4253\/wjge.v6.i10.475"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016\u20105107(03)02364\u20102"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.6092\/1590\u20108577\/3855"},{"key":"e_1_2_10_5_1","first-page":"8286","article-title":"Misdiagnosis of Acute Pancreatitis in a Patient With Foreign Body Ingestion: A Case Report and Literature Review","volume":"14","author":"Yu S.","year":"2022","journal-title":"American Journal of Translational Research"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1055\/a\u20102413\u20107824"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.14309\/crj.0000000000001602"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010013\u20102307\u2010z"}],"container-title":["DEN Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/deo2.70418","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/deo2.70418","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/deo2.70418","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T17:15:32Z","timestamp":1787937332000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/deo2.70418"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,28]]},"references-count":7,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2027,4]]}},"alternative-id":["10.1002\/deo2.70418"],"URL":"https:\/\/doi.org\/10.1002\/deo2.70418","archive":["Portico"],"relation":{},"ISSN":["2692-4609","2692-4609"],"issn-type":[{"value":"2692-4609","type":"print"},{"value":"2692-4609","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,28]]},"assertion":[{"value":"2026-07-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-19","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-28","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70418"}}