{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T17:04:42Z","timestamp":1778864682006,"version":"3.51.4"},"reference-count":14,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"C","license":[{"start":{"date-parts":[[2023,3,1]],"date-time":"2023-03-01T00:00:00Z","timestamp":1677628800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2023,3,1]],"date-time":"2023-03-01T00:00:00Z","timestamp":1677628800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2023,2,17]],"date-time":"2023-02-17T00:00:00Z","timestamp":1676592000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction and importance:<\/jats:title>\n                    <jats:p>Ingested wooden toothpick (WT) represents a rare cause of acute abdomen. Preoperative diagnosis of ingested WT is a challenge because of its unspecific clinical presentation, the low sensitivity rate of radiological investigations and the patient's inability to often recall the event of swallowing a WT. Surgery represents the main treatment in case of ingested WT-induced complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation:<\/jats:title>\n                    <jats:p>\n                      A 72-year-old Caucasian male presented to the Emergency Department with a two-day history of left lower quadrant (LLQ) abdominal pain, nausea, vomiting and fever. Physical examination revealed LLQ abdominal pain and rebound tenderness with muscle guarding. Laboratory tests reported high levels of C-reactive protein and neutrophilic leukocytosis. Abdominal contrast-enhanced computed tomography (CECT) showed colonic diverticulosis, wall thickening of the sigmoid colon, pericolic abscess, regional fatty infiltration, a suspicion of sigmoid perforation secondary to a foreign body. The patient underwent diagnostic laparoscopy: a sigmoid diverticular perforation caused by an ingested WT was noticed and a laparoscopic sigmoidectomy with end-to-end Knight-Griffen colorectal anastomosis, partial omentectomy and protective\n                      <jats:italic toggle=\"yes\">loop ileostomy<\/jats:italic>\n                      were performed. The postoperative course was uneventful.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical discussion:<\/jats:title>\n                    <jats:p>The ingestion of a WT represents a rare but potentially fatal condition which may cause GI perforation with peritonitis, abscesses and other rare complications if it migrates out of the GI tract.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Ingested WT may cause serious GI injuries with peritonitis, sepsis or death. Early diagnosis and treatment are crucial for reducing morbidity and mortality. Surgery is mandatory in case of ingested WT-induced GI perforation and peritonitis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                  <\/jats:sec>","DOI":"10.1016\/j.ijscr.2023.107945","type":"journal-article","created":{"date-parts":[[2023,2,21]],"date-time":"2023-02-21T03:24:48Z","timestamp":1676949888000},"update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":7,"title":["Accidentally ingested wooden toothpick, perforation of a sigmoid diverticulum and mimicking acute colonic diverticulitis"],"prefix":"10.1097","volume":"104","author":[{"given":"Giuseppe","family":"Evola","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giulia","family":"Impellizzeri","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elia","family":"Pulvirenti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"D'Angelo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martina","family":"Reina","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe Angelo","family":"Reina","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"276","reference":[{"key":"R2-28-20260313","doi-asserted-by":"crossref","first-page":"8469","DOI":"10.4076\/1757-1626-2-8469","article-title":"Endoscopic removal of a toothpick perforating the sigmoid colon and causing chronic abdominal pain: a case report","volume":"6","author":"Zezos","year":"2009","journal-title":"Cases J"},{"key":"R3-28-20260313","doi-asserted-by":"crossref","first-page":"S109","DOI":"10.1016\/j.ijscr.2020.09.056","article-title":"Laparoscopic treatment of right colic flexure perforation by an ingested wooden toothpick","volume":"77S","author":"Pattacini","year":"2020","journal-title":"Int J Surg Case Rep"},{"key":"R4-28-20260313","doi-asserted-by":"crossref","first-page":"157","DOI":"10.3393\/ac.2018.04.23","article-title":"Toothpick colon injury mimicking colonic diverticulitis","volume":"34","author":"Jo","year":"2018","journal-title":"Ann Coloproctol"},{"key":"R5-28-20260313","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1016\/j.ijsu.2020.10.034","article-title":"The SCARE 2020 guideline: updating consensus Surgical CAse REport (SCARE) guidelines","volume":"84","author":"Agha","year":"2020","journal-title":"International Journal of Surgery"},{"key":"R6-28-20260313","doi-asserted-by":"crossref","first-page":"4111","DOI":"10.1016\/j.radcr.2022.07.108","article-title":"Abdominal pain from ingested bone misdiagnosed as appendicitis: report of a rare case and literature review","volume":"17","author":"Asaad","year":"2022","journal-title":"Radiol Case Rep"},{"key":"R7-28-20260313","first-page":"MC6046542","article-title":"M., Tahir K.S., Gubari M.I.N., Rasul R.H.K., Rashid M.J., Aziz J.M.Abdul, Large trichobezoar associated with misdiagnosis, a rare case report with a brief literature reviewJunInt J Surg Case Rep. 88 (2021), 106551, https:doi.org10.1016j.ijscr.2021.106551. 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