Original title: Endoscopic Removal of a Toothpick Penetrating the Gastric Wall and Extending Into the Head of the Pancreas: A Case Report and Brief Literature Review
Ken Nakayama, Takanori Ueda, Noriyuki Isohata, Tadashi Kondo +6 · August 2026
Swallowed toothpicks can poke holes in the gut and pierce nearby organs. Reaching the pancreas is rare, and doctors usually debate between surgery and endoscopy to treat it. Doctors treated a 59-year-old man who had a fever and upper belly pain for 5 days. Scans showed a sharp object had poked through his stomach wall and stuck into the head of his pancreas. Instead of performing open surgery, the team used an endoscope, which is a flexible camera tube put down the throat. Under conscious sedation, doctors guided biopsy forceps through a protective overtube, grabbed the exposed wooden tip inside the stomach, and pulled it out safely. The removed object was a 6.5-cm wooden toothpick. The patient recovered smoothly without complications, showing that endoscopy can safely fix this problem without invasive surgery.
Imagine you drop a sewing needle into a couch cushion and it pokes through the fabric into the foam underneath. Normally you'd have to cut open the cushion to get it out. But if you can see exactly where the needle is and grab it with long tweezers through the original hole, you can remove it without cutting. In this paper, the toothpick was like that needle, and the endoscope was the long tweezers—doctors pulled it out through the stomach without opening the abdomen.
Swallowing a toothpick is rare but dangerous—it can stab through the gut into organs like the pancreas, often requiring major surgery. This case shows that in the right circumstances, doctors can remove it with a flexible tube down the throat instead, avoiding an open operation. That means less pain, faster recovery, and lower risk for the patient.
This is a single case report, so the approach may not work for all patients. The abstract does not specify criteria for selecting candidates, and the procedure required surgical backup, meaning it was not attempted without a safety net. The toothpick's wooden composition and straight trajectory likely made endoscopic removal feasible, but other foreign bodies or deeper penetration might still require surgery.
Ask anything about this paper. Answers come from its abstract, and say so when the abstract doesn't cover your question.
Endoscopic Removal of a Toothpick Penetrating the Gastric Wall and Extending Into the Head of the Pancreas: A Case Report and Brief Literature Review — Ken Nakayama, Takanori Ueda, Noriyuki Isohata et al. — DEN open — doi:10.1002/deo2.70418
Abstract licence: CC BY
Explanation generated by Synthesis from the abstract — it is not the original paper.