During the Spring Festival, Xiao Wu swallowed a toothpick in his mouth after a friend’s party and accidentally swallowed it into his belly without any discomfort, so he did not pay special attention to it and did not go to the clinic for medical treatment. After hospitalization, abdominal X-ray, gastroscopy and colonoscopy were performed, but the toothpick was not seen, so the toothpick was suspected to be in the small intestine, and CT examination was performed, which showed that the toothpick was fixed in the upper part of the jejunum. Minimally invasive laparoscopy with three small holes in the abdominal wall can also be removed and is among the options.
Dr. Tang Shilong of the Department of General Surgery and Dr. Jiang Di of the Department of Gastroenterology discussed together that the gastroscope and duodenum could not be removed due to insufficient length, and the enteroscope could not reach the site of the toothpick by entering through the anus. Since the two doctors had experience working together to treat small intestine bleeding, they came up with a bold and clever solution: Isn’t the colonoscope larger than 100 cm? Wouldn’t the colonoscope enter through the mouth and reach the site where the toothpick was located? The first is that the colonoscope is too thick and must be intubated under general anesthesia in order to safely enter through the mouth for upper gastrointestinal examination and treatment, and the second is that the duodenal bend is large, so it is difficult for non-very skilled endoscopists to enter the small intestine smoothly. After the two doctors studied, they felt that these were not problems.
After successful anesthesia, Dr. Jiang and Dr. Tang successfully entered the colonoscope from the mouth into the small intestine according to the established protocol, and indeed, a toothpick with two sharp ends of about 4 cm was seen in the upper jejunum, and both tips pierced the small intestine wall, which was red and infected. The wall was red, swollen and infected. The next day, Xiao Wu was able to eat normally, and the symptoms of fever, abdominal pain and blood in stool disappeared, and soon Xiao Wu was happily discharged from the hospital.