Management of chronic abdominal pain due to an unnoticed ingested wooden toothpick in a low resource setting

Abstract

It is well known that humans can ingest foreign bodies in their diet. These may end up causing serious gastrointestinal injuries and chronic pain. We present a case of a teenage male with no known psychological disorder, who suffered from abdominal pain
for over 5 months. This pain went increasing with time, and was exacerbated during diets. He had been on medical treatment for peptic ulcer disease with no remission of the pain. His psychological evaluation was normal; no serious abnormality was
discovered during physical examination. His blood workup was normal except for an elevated white blood cell count of 10,000 /mm3. Computed tomography images showed images of a chronic inflammatory process around the epigastric region. the exacerbation
of the pain following failure to a medical treatment led an exploratory laparotomy during which a toothpick was found perforating the walls of adjacent intestinal loops. The foreign body was removed, and intestinal bowel loops repaired. Many causes of chronic
abdominal pains exist but foreign body ingestion should be considered in cases of chronic pain refractory to medical treatment.