Intragastric Foreign Body: A Case Study

Abstract

We report the case of a 25-year-old female patient seen in consultation for foreign body ingestion. The patient had swallowed a toothbrush for 10 days. The study aims to report and analyse a case of an intragastric foreign body, highlighting its diagnosis, management, and outcomes. After swallowing the brush, she consulted a health facility where a laxative and analgesic-based treatment was instituted, and she was reassured that the brush would come out in the stool. When she failed to see the brush in the stool and experienced additional abdominal pain, she consulted us for treatment.  She had no previous medical or surgical history. Oesogastroduodenal endoscopy revealed a toothbrush, part of which was downstream of the pylorus. We attempted extraction using the diathermic loop. After several unsuccessful attempts, we observed the lower part of the brush embedded in the wall (or mucosa) of the descending duodenum (D2), with suspected perforation. We therefore proposed surgical management, which involved the extraction of a toothbrush by approaching the duodenal bulb, followed by epiplooplasty. Post-operative management was straightforward. Foreign body ingestion is most often accidental, as in our patient. Endoscopy remains the most appropriate extraction method, but if extraction by this route is not possible, surgery remains a good alternative.