A laparoscopic appendectomy and a full-thickness double running suture of the perforation were performed.Īwareness about dangers of ingested toothpicks needs to be taken and the intestinal track/trace of the toothpick is mandatory until its expulsion.įoreign bodies Laparoscopic suture Wooden toothpick.Ĭopyright © 2020. There was also an acute phlegmonous appendicitis. The presence of local peritonitis at the right colonic flexure secondary to a full thickness bowel perforation caused by a toothpick was found. Indication to surgery was posed and an explorative laparoscopy was performed. Laboratory blood count reported leukocytosis and alteration of principal inflammation index at the abdominal ultrasound no signs of perforation or collection were described. ascending colon, part of the large intestine that is continuous with the cecum proximally and the transverse colon at the right colic (hepatic) flexure. A) descending colon B) cecum C) transverse colon D) sigmoid colon E) ascending colon The muscularis externa of the large intestine differs from that of other intestinal regions because the longitudinal layer has been reduced to the muscular bands of the. Lymphatic drainage of the splenic flexure is. The hepatic flexure receives its blood supply in part from the right colic vessels and in part from the middle colic vessels Normal hepatic flexure The beginning and end of the hepatic flexure are ill defined, but it connects the ascending colon with the transverse colon. Abdominal X-ray showed, in addition to a few air filled dilated bowel loops consistent with partial bowel obstruction, a large mass in the left hemi-abdomen. We present the case of a 42-years old man who was admitted to the emergency department at our Institution presenting with a 5-days history of right sided abdominal pain. Transcribed image text: At the right colic flexure, the curves anteriorly and crosses the abdomen from right to left. It is supplied by the left branches of the midcolic vessels and the upper branches of the left colic vessels. Ingestion of a toothpick, both accidentally and intentionally, is a rare event.
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