Toothpick-Induced Pancreatitis: Case Report, Review of Literature, and Proposed Management Approach

Most ingested foreign bodies are expelled naturally without complications. However, serious concerns such as obstruction, bleeding, and perforation can occur. Sharp foreign objects like toothpicks may reach the pancreas by penetrating the small bowel or stomach, leading to pancreatitis. We present the case of a 13-year-old male who arrived with epigastric pain and vomiting and was found to have toothpick-induced pancreatitis after accidental ingestion. The toothpick was successfully removed endoscopically from the third part of the duodenum without any complications. Pancreatitis due to toothpick ingestion is extremely rare and the limited literature makes optimal management unclear. Clinicians should therefore remain vigilant and consider foreign body ingestion as a potential differential diagnosis in patients presenting with unexplained pancreatitis. To address this gap, we complement this case with a comprehensive literature review of all cases of foreign bodies resulting in pancreatitis and propose a structured algorithm to help guide decision-making between endoscopic and surgical management.