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Case Reports in Medicine
Volume 2017, Article ID 5846290, 4 pages
Case Report

Toothpick inside the Common Bile Duct: A Case Report and Literature Review

1Gastroenterology Department, Faculty of Medicine, University of São Paulo, 05403-001 São Paulo, SP, Brazil
2Pathology Department, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
3Division of Digestive Endoscopy and General Surgery, Carlos Fernando Malzoni Hospital, Matão, SP, Brazil
4Digestive Surgery Department, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil

Correspondence should be addressed to V. O. Brunaldi; moc.liamg@idlanurbv

Received 14 August 2016; Revised 18 January 2017; Accepted 29 January 2017; Published 5 March 2017

Academic Editor: William B. Silverman

Copyright © 2017 V. O. Brunaldi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


The incidence and prevalence of foreign body (FB) ingestion are difficult to estimate. Unlike other foreign bodies, the ingestion of a toothpick is very uncommon and carries high morbidity and mortality rates. We report a case of a 73-year-old female patient presenting mid-term epigastric pain. Abdominal ultrasound revealed a slightly dilated common bile duct (CBD) and magnetic resonance showed an irregular filling failure in distal CBD and gallstones. Endoscopic Retrograde Cholangiopancreatography revealed major papilla on the edge of a diverticulum and confirmed the distal filling failure. After sphincterotomy, a partially intact toothpick was extracted from the CBD. Neither fistulas nor perforation signs were found. Literature related to foreign bodies and toothpick ingestion was reviewed and some hypotheses to explain the reported case were created. To our knowledge, this is the first report of a toothpick lodged inside the biliary tract.