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13.01.2022 | Original Article

Accidental or intentional ingestion of toothbrushes: experience with 8 adult patients

verfasst von: Gary G. Ghahremani, Katherine M. Richman

Erschienen in: Emergency Radiology | Ausgabe 2/2022

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Abstract

Purpose

Ingestion of a toothbrush is an unusual event but may occur either accident or by intent. Radiological examinations play a crucial role in determining the exact location of the object within the gastrointestinal tract and in planning for its removal by endoscopic or surgical intervention.

Methods

Medical and radiological records of 8 patients who had swallowed the broken heads or entire toothbrush were retrospectively reviewed. This series included 4 men and 4 women, ranging in age from 21 to 57 years (mean: 34 years).

Results

Radiographs and computed tomography of the abdomen demonstrated the ingested toothbrushes within the stomach in 3, lodged in the duodenum in 1, and entrapped in various parts of the colon in 4 patients. They were removed by laparotomy in 3, laparoscopy in 2, colonoscopy in 2, and upper gastrointestinal endoscopy in 1 patient. There were no perforations or associated complications, and all patients had uneventful recoveries.

Conclusions

Ingested toothbrushes can be easily identified on radiological studies because of the radiopaque wires holding the nylon bristles. The plastic parts of it, however, are only visible on computed tomography. All cases would require endoscopic or surgical removal of the retained toothbrushes because spontaneous passage per rectum does not occur.
Literatur
1.
Zurück zum Zitat Kraeft JJ, Uppot RN, Heffess AM (2013) Imaging findings in eating disorders. Am J Roentgenol 200:328–235CrossRef Kraeft JJ, Uppot RN, Heffess AM (2013) Imaging findings in eating disorders. Am J Roentgenol 200:328–235CrossRef
2.
Zurück zum Zitat Riddelsberger MM, Cohen HL, Glick PI (1991) The swallowed toothbrush: a radiographic clue of bulimia. Pediat Radiol 21:262–264CrossRef Riddelsberger MM, Cohen HL, Glick PI (1991) The swallowed toothbrush: a radiographic clue of bulimia. Pediat Radiol 21:262–264CrossRef
3.
Zurück zum Zitat Mughal M (1986) Accidental ingestion of a toothbrush. Arch Emerg Med 3:119–223CrossRef Mughal M (1986) Accidental ingestion of a toothbrush. Arch Emerg Med 3:119–223CrossRef
4.
Zurück zum Zitat Kiran S, Gupta D, Sadalage A, Gupta A, Jain A, Shukla A (2016) Swallowed toothbrush: case series. J Digest Endosc 7:77–79CrossRef Kiran S, Gupta D, Sadalage A, Gupta A, Jain A, Shukla A (2016) Swallowed toothbrush: case series. J Digest Endosc 7:77–79CrossRef
5.
Zurück zum Zitat Mahwish K, Ali SM, Rashad AF, Mohamed Y, Inmullah N, Hafiz AA et al (2017) Duodenal perforation by swallowed toothbrush: case report and review of literature. Open Access J Surg 4:E555632 Mahwish K, Ali SM, Rashad AF, Mohamed Y, Inmullah N, Hafiz AA et al (2017) Duodenal perforation by swallowed toothbrush: case report and review of literature. Open Access J Surg 4:E555632
6.
Zurück zum Zitat Harvey M, Cave G, Prince G (2012) Endoscopic removal of an inadvertently swallowed toothbrush in the emergency department. Case Rep Emerg Med 2012:E568163 Harvey M, Cave G, Prince G (2012) Endoscopic removal of an inadvertently swallowed toothbrush in the emergency department. Case Rep Emerg Med 2012:E568163
7.
Zurück zum Zitat Ertan A, Akdamar K, Litwink MS (1983) Endoscopic removal of a toothbrush. Gastrointest Endosc 29:144–145CrossRef Ertan A, Akdamar K, Litwink MS (1983) Endoscopic removal of a toothbrush. Gastrointest Endosc 29:144–145CrossRef
8.
Zurück zum Zitat Tonkic A, Bogdanovic Z (2011) Grandic L (2011) Successful endoscopic removal of a swallowed toothbrush: case report. Case Rep Gastroenterol 5:122–124CrossRef Tonkic A, Bogdanovic Z (2011) Grandic L (2011) Successful endoscopic removal of a swallowed toothbrush: case report. Case Rep Gastroenterol 5:122–124CrossRef
9.
Zurück zum Zitat Wishner JD, Rogers AM (1997) Laparoscopic removal of a swallowed toothbrush. Surg Endosc 11:472–473CrossRef Wishner JD, Rogers AM (1997) Laparoscopic removal of a swallowed toothbrush. Surg Endosc 11:472–473CrossRef
10.
Zurück zum Zitat Sewpaul A, Shaban F, Venkatasubramaniam AK, Tenant D, Kelly SB (2012) The case of the forgotten toothbrush. Int J Surg Rep 3:184–185CrossRef Sewpaul A, Shaban F, Venkatasubramaniam AK, Tenant D, Kelly SB (2012) The case of the forgotten toothbrush. Int J Surg Rep 3:184–185CrossRef
11.
Zurück zum Zitat Lu XL, Cao HL, Qian KD (2008) Endoscopic removal of an accidentally swallowed toothbrush. Int Med 47:1797–1798CrossRef Lu XL, Cao HL, Qian KD (2008) Endoscopic removal of an accidentally swallowed toothbrush. Int Med 47:1797–1798CrossRef
12.
Zurück zum Zitat Kirk AD, Bowers BA, Moylan JA, Meyers WC (1988) Toothbrush swallowing. Arch Surg 123:382–384CrossRef Kirk AD, Bowers BA, Moylan JA, Meyers WC (1988) Toothbrush swallowing. Arch Surg 123:382–384CrossRef
13.
Zurück zum Zitat Sakki TK, Knuuttila MLE, Anttila SS (1998) Lifestyle, gender and occupational status as determinants of dental health behavior. J Clin Periodontol 25:566–570CrossRef Sakki TK, Knuuttila MLE, Anttila SS (1998) Lifestyle, gender and occupational status as determinants of dental health behavior. J Clin Periodontol 25:566–570CrossRef
14.
Zurück zum Zitat Augner R (2007) Tooth brushing as routine behaviour. Int Dent J 57:364–376CrossRef Augner R (2007) Tooth brushing as routine behaviour. Int Dent J 57:364–376CrossRef
15.
Zurück zum Zitat Poynter BA, Hunter JJ, Coverdale JH, Kempinsky CA (2011) Hard to swallow: a systematic review of deliberate foreign body ingestion. Gen Hosp Psychiatry 33:518–524CrossRef Poynter BA, Hunter JJ, Coverdale JH, Kempinsky CA (2011) Hard to swallow: a systematic review of deliberate foreign body ingestion. Gen Hosp Psychiatry 33:518–524CrossRef
16.
Zurück zum Zitat Varnik P (2012) Suicide in the world. Int J Environ Res Public Health 9:760–771CrossRef Varnik P (2012) Suicide in the world. Int J Environ Res Public Health 9:760–771CrossRef
17.
Zurück zum Zitat Voelker MA, Bayne SC, Liu Y, Walker MP (2013) Catalogue of tooth brush head designs. J Dent Hyg 87:118–133PubMed Voelker MA, Bayne SC, Liu Y, Walker MP (2013) Catalogue of tooth brush head designs. J Dent Hyg 87:118–133PubMed
18.
Zurück zum Zitat Chao HH, Chao TC (2008) Perforation of the duodenum by an ingested toothbrush. World J Gastroenterol 14:4410–4412CrossRef Chao HH, Chao TC (2008) Perforation of the duodenum by an ingested toothbrush. World J Gastroenterol 14:4410–4412CrossRef
19.
Zurück zum Zitat Lee MR, Hwang Y, Kim JH (2006) A case of colohepatic penetration by a swallowed toothbrush. World J Gastroenterol 12:2464–2465CrossRef Lee MR, Hwang Y, Kim JH (2006) A case of colohepatic penetration by a swallowed toothbrush. World J Gastroenterol 12:2464–2465CrossRef
20.
Zurück zum Zitat Kim IH, Kim HC, Koh KH, Kim SH, Kim SW, Lee SO, Lee ST (2007) Journey of a swallowed toothbrush to the colon. Korean J Int Med 22:106–108CrossRef Kim IH, Kim HC, Koh KH, Kim SH, Kim SW, Lee SO, Lee ST (2007) Journey of a swallowed toothbrush to the colon. Korean J Int Med 22:106–108CrossRef
21.
Zurück zum Zitat Jamal K, Shaunak S, Kalsi S, Nehra D (2013) Successful laparoscopic removal of an ingested toothbrush. J Surg Tech Case Rep 4:99–102 Jamal K, Shaunak S, Kalsi S, Nehra D (2013) Successful laparoscopic removal of an ingested toothbrush. J Surg Tech Case Rep 4:99–102
22.
Zurück zum Zitat Cox D, Donohue P, Costa V (2007) A swallowed toothbrush causing perforation 2 years after ingestion. Br J Hosp Med 68:559CrossRef Cox D, Donohue P, Costa V (2007) A swallowed toothbrush causing perforation 2 years after ingestion. Br J Hosp Med 68:559CrossRef
23.
Zurück zum Zitat Zong Y, Zhao H, Sun C et al (2020) Differences between intentional and accidental ingestion of foreign body in China. BMC Gastroenterol 20:90CrossRef Zong Y, Zhao H, Sun C et al (2020) Differences between intentional and accidental ingestion of foreign body in China. BMC Gastroenterol 20:90CrossRef
24.
Zurück zum Zitat Huang BL, Rich HG, Simundson SE et al (2010) Intentional swallowing of foreign bodies is a recurrent and costly problem that rarely causes endoscopy complications. Clin Gastroenterol Hepatol 8:941–946CrossRef Huang BL, Rich HG, Simundson SE et al (2010) Intentional swallowing of foreign bodies is a recurrent and costly problem that rarely causes endoscopy complications. Clin Gastroenterol Hepatol 8:941–946CrossRef
25.
Zurück zum Zitat Salazar JAD, Pacheco NCN, Jaramillo PAP et al (2020) Ingestion of razor blades, a rare event: a case report in a psychiatric patient. J Surg Case Rep 5:1–3 Salazar JAD, Pacheco NCN, Jaramillo PAP et al (2020) Ingestion of razor blades, a rare event: a case report in a psychiatric patient. J Surg Case Rep 5:1–3
26.
Zurück zum Zitat Lee JH (2018) Foreign body ingestion in children. Clin Endosc 51:129–136CrossRef Lee JH (2018) Foreign body ingestion in children. Clin Endosc 51:129–136CrossRef
27.
Zurück zum Zitat Panieri E, Bass DH (1995) The management of ingested foreign bodies in children-a review of 663 cases. Euro J Emerg Med 2:83–87CrossRef Panieri E, Bass DH (1995) The management of ingested foreign bodies in children-a review of 663 cases. Euro J Emerg Med 2:83–87CrossRef
28.
Zurück zum Zitat Sasaki T, Toriumi S, Asakage T et al (2006) The toothbrush: a rare but potentially life-threatening cause of penetrating oropharyngeal trauma in children. Pediatr 118:1284–1286CrossRef Sasaki T, Toriumi S, Asakage T et al (2006) The toothbrush: a rare but potentially life-threatening cause of penetrating oropharyngeal trauma in children. Pediatr 118:1284–1286CrossRef
29.
Zurück zum Zitat Aggarwal MK, Singh GB, Dhawan R, Kumar R (2009) Rare case of a broken toothbrush as a parapharyngeal space foreign body. J Otolaryng Head Neck Surg 38:107–109 Aggarwal MK, Singh GB, Dhawan R, Kumar R (2009) Rare case of a broken toothbrush as a parapharyngeal space foreign body. J Otolaryng Head Neck Surg 38:107–109
Metadaten
Titel
Accidental or intentional ingestion of toothbrushes: experience with 8 adult patients
verfasst von
Gary G. Ghahremani
Katherine M. Richman
Publikationsdatum
13.01.2022
Verlag
Springer International Publishing
Erschienen in
Emergency Radiology / Ausgabe 2/2022
Print ISSN: 1070-3004
Elektronische ISSN: 1438-1435
DOI
https://doi.org/10.1007/s10140-021-02009-x

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