A humble toothpick is being blamed for causing severe abdominal pain for an Australian woman after it was found by surprise in her gut during surgery.
Doctors in Melbourne were stunned to find the toothpick in the 70-year-old woman's colon during an operation they were carrying out after diagnosing her with acute diverticulitis, a condition that causes the walls of the large bowel to become inflamed.
Before the surgery, the woman had turned up with abdominal pain four times in a month at a hospital emergency department.
But when her doctors began operating, they found part of her colon had ballooned in size and been pierced by a toothpick.
Routine scans carried out before the surgery didn't detect any foreign objects in her gut, and even after the operation the woman denied she'd used toothpicks or eaten a meal served with the tiny wooden sticks.
Details of the case were included among hundreds of other intriguing medical mysteries published as case reports by the British Medical Journal on Wednesday.
The woman's doctors, Shanesh Kumar, Ramin Mehdipour, Asiri Arachchi, and Antony Cass, said that given half of all patients who end up ingesting toothpicks don't realise they have swallowed one, medics should consider checking for foreign objects in patients with abdominal pain.
"Appropriate pre-operative investigations such as endoscopy and CT, despite their fairly low sensitivity, should be performed to increase the ability to accurately diagnose this condition and therefore optimise subsequent management," they wrote in their case report.
Included in the BMJ's other case reports were details about how a British woman was nearly blinded after a piece of glitter from a Christmas card lodged in her eyeball.
Her doctors in England initially thought her swollen eye was caused by a herpes simplex infection.
However a powerful microscope helped them detect a tiny piece of glitter, which the woman later recalled lodged in her eye after coming loose from a Christmas card.
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