CASE 479: TOOTHPICK PERFORATED BILIARY DUODENUM, Dr PHAN THANH HẢI-Dr LÊ THỊ THANH THẢO, MEDIC MEDICAL CENTER, HCMC, VIETNAM.

Man 74 yo with epigastric pain, being treated like gastric ulcer.

Ultrasound of abdomen  detected  one hyperechoic foreign body # 3.5 cm which penetrated  gastro-duodenum wall  to gallbladder. The  gallblader wall is very thick # 1 cm.

MSCT of  abdomen made diagnosis  that was a toothpick  penetrated from gastric wall to  gallbladder.

Operation removed this toothpick and cholecystectomy.

Conclusion:  Toothpick perforated gastric wall to gallbladder, an emergency case must be known.

REFERENCE: CASE 232.