{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T22:05:59Z","timestamp":1773353159389,"version":"3.50.1"},"reference-count":20,"publisher":"BMJ","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["BMJ Case Reports"],"abstract":"<jats:p>A 77-year-old edentulous man presented to the accident and emergency department with a sudden onset of sharp right-sided abdominal pain. The patient reported a change in his bowel habit with constipation over a 6\u2005month period but did not report any significant choking event or ingestion of a foreign body in the preceding months. On examination the patient was maximally tender with guarding over McBurneys point. CT scan showed an abnormal segment of distal ileum with a 3\u2005cm high attenuation focus which had penetrated the bowel wall. At laparotomy the patient was found to have a perforation of his distal ileum caused by an ingested toothpick. Patients wearing dental plates or dentures are at higher risk of toothpick ingestion due to impaired palatal sensation. CT scanning, in the appropriate setting, may aid diagnosis and lower operator risk of sharp related injury at the time of operation.<\/jats:p>","DOI":"10.1136\/bcr-2013-009869","type":"journal-article","created":{"date-parts":[[2013,8,9]],"date-time":"2013-08-09T09:08:20Z","timestamp":1376039300000},"page":"bcr2013009869","source":"Crossref","is-referenced-by-count":4,"title":["Radiological diagnosis of a small bowel perforation secondary to toothpick ingestion"],"prefix":"10.1136","volume":"2013","author":[{"given":"David","family":"Mark","sequence":"first","affiliation":[{"name":"Department of General Surgery, Ulster Hospital, Belfast, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathryn","family":"Ferris","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Ulster Hospital, Belfast, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gareth","family":"Martel","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Ulster Hospital, Belfast, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Keith","family":"Mulholland","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Ulster Hospital, Belfast, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2013,8,9]]},"reference":[{"key":"2025082800410366000_2013.aug09_1.bcr2013009869.1","first-page":"52","article-title":"Computed tomographic detection of toothpick perforation of the jejunum: case report and literature review","volume":"2013","author":"Reginelli","year":"2007","journal-title":"Radiol Case Rep"},{"key":"2025082800410366000_2013.aug09_1.bcr2013009869.2","doi-asserted-by":"crossref","first-page":"227","DOI":"10.1001\/archsurg.1971.01350030065021","article-title":"Penetration of the alimentary tract by a foreign body with migration to the liver","volume":"2013","author":"Abel","year":"1971","journal-title":"Arch Surg"},{"key":"2025082800410366000_2013.aug09_1.bcr2013009869.3","first-page":"899","article-title":"A case of an intrahepatic fish bone penetration\u2014possibility of the preoperative diagnosis by CT scan","volume":"2013","author":"Tsuboi","year":"1981","journal-title":"Arch Jpn Chir"},{"key":"2025082800410366000_2013.aug09_1.bcr2013009869.4","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1016\/S0736-4679(02)00458-4","article-title":"Toothpick injury mimicking renal colic: case report and systematic review","volume":"2013","author":"Li","year":"2002","journal-title":"J Emerg Med"},{"key":"2025082800410366000_2013.aug09_1.bcr2013009869.5","doi-asserted-by":"crossref","first-page":"820","DOI":"10.1148\/radiographics.19.3.g99ma20820","article-title":"Gastrointestinal case of the day. 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