BRIEF RESEARCH REPORT article
Front. Surg.
Sec. Visceral Surgery
Volume 12 - 2025 | doi: 10.3389/fsurg.2025.1610269
Toothpick-Induced superior mesenteric artery -Duodenal Fistula with Thrombosis: A Rare Case Report
Provisionally accepted
- Binzhou People’s Hospital, Binzhou, China
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Background: Ingestion of foreign bodies, particularly sharp objects like toothpicks, can lead to severe gastrointestinal complications. This case report describes a rare instance of a superior mesenteric artery (SMA)-duodenal fistula with subsequent SMA thrombosis caused by a toothpick.Presentation: A 47-year-old woman presented with persistent upper abdominal pain. Abdominal CT revealed increased density around the pancreatic neck. Further CT reconstruction identified a linear foreign body in the duodenum, which was confirmed as a toothpick during surgery. The toothpick had perforated the duodenum and pancreas. Postoperatively, the patient developed lower abdominal pain, melena, and declining hemoglobin levels. Enhanced CT indicated SMA thrombosis. Despite attempts to recanalize the SMA, conservative management was pursued due to good collateral circulation. The patient recovered well and was discharged after stabilization. Conclusion: This case highlights the potential for toothpick ingestion to cause rare and severe complications, including fistula formation and arterial thrombosis.Clinicians should be vigilant about foreign body ingestion in cases of unexplained abdominal pain and consider comprehensive management strategies to prevent catastrophic outcomes.
Keywords: No. 515, Huanghe Seventh Road, Bincheng District, Binzhou city, Shan dong Province Toothpick, SMA-duodenal fistula, SMA thrombosis, foreign body
Received: 11 Apr 2025; Accepted: 30 May 2025.
Copyright: © 2025 Sun, Lu, Ding and Xue. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Minmin Lu, Binzhou People’s Hospital, Binzhou, China
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