Unusual Differential Diagnosis of Upper Abdominal Pain

We here present an interesting unusual case of upper abdominal pain. The patient was a 38-year-oldman, who was admitted to our
hospital complaining of right upper quadrant pain caused by a toothpick that perforated the anterior gastric wall and penetrated
segment I of the liver. After endoscopic removal and an initially uneventful course, computed tomography revealed a perigastric
abscess that was treated by repeated gastroscopic rinsing via an endoscopically placed catheter. After another three uneventful
weeks, a liver abscess with minor tendency to constrict the portal vein was diagnosed, and a segment I liver resection together with
abscess drainage was performed. The peculiarity of this case is the rarity of toothpick ingestion and gastric perforation in a young
and healthy white Caucasian followed by development of a liver abscess after primary uneventful endoscopic removal. In light of
this case, gastric perforation due to ingested foreign bodies such as toothpicks can be considered a rare cause of upper abdominal
pain.


Encuentran el articulo completo en pdf en el siguiente LINK: http://www.hindawi.com/journals/dte/2009/817052.html