In Vietnam, 7cm toothpick removed after over 4 months inside boy's abdomen

The patient, identified as T.V.G.B. from neighboring Binh Duong Province, began experiencing persistent left abdominal pain and recurring fever in January 2025.

An initial medical evaluation at a local hospital found fluid accumulation around the spleen, and he was diagnosed with a spleen injury, possibly caused by a swimming-related trauma.

During a trip to his hometown for the 2025 Lunar New Year (Tet) celebration, further examination at a larger hospital still showed residual fluid near the spleen.

The boy was prescribed medication and continued to be monitored at home.

However, on May 11, his condition worsened significantly with a high fever and severe abdominal pain, prompting emergency admission to a nearby hospital.

Due to concerns about a serious infection, doctors transferred him to Children's Hospital 2 in Ho Chi Minh City for further evaluation.

An ultrasound revealed a sharp, elongated foreign object in the boy’s abdomen.

Surgeons performed an emergency laparoscopic surgery, and to the family’s shock, the object removed was a wooden toothpick.

According to his family, the boy often eats in a rush and does not chew thoroughly, so he may have accidentally swallowed the toothpick without realizing it.

The toothpick had punctured the lower part of the duodenum, leading to prolonged inflammation and fluid buildup in the space between the spleen and kidney, as well as at the lower pole of the spleen.

This was the underlying cause of his months-long recurring symptoms.

The boy is now in stable condition and recovering under observation in the hospital's general surgery department.

Dr. Bui Hai Trung, deputy head of the general surgery department, and the lead surgeon in this case, emphasized that swallowing foreign objects is a potentially dangerous accident, particularly common in children between six months and three years old.

While most cases do not result in severe outcomes, a small percentage, less than one percent, can lead to serious complications, such as gastrointestinal obstruction, perforation, or infection.

Dr. Trung said that toothpicks are commonly used after meals and may be unconsciously held in the mouth, increasing the risk of accidental ingestion during talking, laughing, or playing.

At Children’s Hospital 2, several similar cases have been documented.

As toothpicks are made of wood and not radio-opaque, they often do not appear on X-rays, leading to delayed or missed diagnoses.

Early symptoms may be vague or absent, making it easy for both caregivers and medical workers to overlook the danger.

Dr. Trung urged parents and schools to strictly prevent children from holding toothpicks in their mouths.

The doctor recommended teaching children to use dental floss or toothbrushes for oral hygiene instead.

Used toothpicks should be discarded in lidded trash bins to prevent accidental access by children.

If there is any suspicion that a child has swallowed a toothpick, even in the absence of clear symptoms, immediate evaluation at a healthcare facility equipped with ultrasound or CT imaging is essential to avoid life-threatening complications.