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March 14, 2026CureusOpen Access

Needle in a Radiologic Haystack: A Report of Duodenal Toothpick Perforation With Negative X-ray and CT Imaging

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Authors

JWJonathan WarrenNPNiresh C PereraFLFlor Lema

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Overview

Case report reveals toothpick perforation in a young male, highlighting challenges in radiolucent object diagnosis.

Key Points

  • To present a rare case of duodenal perforation by a wooden toothpick that was undetectable by X-ray and CT imaging.
  • Patient presented to urgent care with suspected toothpick ingestion.
  • Initial X-ray and multi-region CT scans were performed and showed no abnormalities.
  • Gastroenterology did an endoscopy after negative imaging results.
  • A wooden toothpick measuring 4-5 cm was found embedded in the duodenum.
  • The toothpick caused perforation but initially went undetected on imaging.
  • The foreign body was removed successfully without complications.

Cite This Study

Warren et al. (2026) studied this question.

synapsesocial.com/papers/69b4fa6fb39f7826a300b342https://doi.org/10.7759/cureus.105006
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Laparoscopic Management of Jejunal Perforation by a Toothpick: A Case Report2025
  2. 2Radiolucent Plastic Food Pick Ingestion in a Child: Endoscopic Retrieval Despite Negative CT Findings2025
  3. 3Case report and literature review: Orally ingested toothpick perforating the lower rectum2024 · 1 citations
  4. 4Bladder Foreign Body of Gastrointestinal Origin: A CaseReport and Literature Review2026
  5. 5Endoscopic Removal and Conservative Treatment of a Small Bowel Perforation Caused by a Toothpick: A Case Report2024 · 1 citations