Indian Journal of Surgery

, Volume 81, Issue 6, pp 604–606 | Cite as

Perforation of Cecum Secondary to Foreign Body—Toothpick

  • Jothi Rajasekaran MurugesanEmail author
  • Tom Palesy
  • Alexander Engel
Images in Surgery


Intestinal perforation from foreign bodies is not uncommon. Toothpick perforation of the cecum is rare both site wise and as an etiology of perforation involving the large intestine. We report a case involving a 65-year-old female whose presentation was with nausea, vomiting, and lower abdominal pain of 4 weeks duration. Clinical examination at presentation revealed tenderness in the right iliac fossa with peritonism. Blood results showed marginally elevated inflammatory markers. Computerized tomography (CT scan) of the abdomen and pelvis showed localized perforation of the cecum. Laparoscopy showed cecal perforation adjacent to the ileocecal valve; hence, a right hemicolectomy was performed. Histopathological examination confirmed the above finding. Foreign body perforation of large intestine, although rare, should be a differential for acute abdominal pain. A thorough history, examination, and pertinent imaging are vital to arrive at an early diagnosis and hence management plan.


Foreign body Ingestion Toothpick Perforation Cecum Large intestine 


Compliance with Ethical Standards


A written consent was obtained from the patient to permit us to publish this case report and images.

Conflict of Interest

The authors declare that they have no conflict of interest.


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Copyright information

© Association of Surgeons of India 2019

Authors and Affiliations

  1. 1.Department of Colorectal SurgeryRoyal North Shore HospitalSt LeonardsAustralia
  2. 2.University of SydneySydneyAustralia

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