Swallowed toothpick causes blood poisoning

Posted 11/09/2012

The BBC has reported on a case where a woman developed severe blood poisoning and a liver abscess after inadvertently swallowing a toothpick. The toothpick perforated her gullet and lodged in a lobe of her liver. Such cases are rare, but the report, published by the British Medical Journal, says doctors need to look out for signs of “foreign bodies”, as detection can be challenging.

Swallowing foreign bodies is relatively common, particularly among children. The condition has mostly been associated with inadvertently swallowing pins, nails, fish and chicken bones, rather than toothpicks. However, the authors said toothpicks could be “difficult to deal with effectively, because they don’t show up on conventional X-rays and symptoms are often non-specific and remote”.

In this particular case, the woman was admitted to hospital with generalised gut pain and fever, accompanied by nausea, vomiting, and low blood pressure. An abdominal ultrasound scan revealed a liver abscess and the presence of a toothpick lodged in her liver. She subsequently developed breathing difficulties and an infection as a result of blood poisoning and had to be admitted to intensive care. After treatment with antibiotics, she recovered and the toothpick was removed using keyhole surgery, after which all her symptoms cleared.

Sophie Bales, medical injury solicitor at Ashtons Legal, comments:

“This case highlights the difficulty in identifying foreign bodies in the abdomen, liver and bowel by a normal x-ray and the importance of performing a CT scan if generalised symptoms such as gut pain, nausea and fever persist or if a patient has a drastic and consistent change in their bowel habit.  We have had several cases where swabs or other instruments have been negligently left in situ following an operation. It is important that such objects are identified and removed as quickly as possible to avoid any potentially dangerous consequences.”