Perforation of Cecum Secondary to Foreign Body—Toothpick

Intestinal perforation from foreign bodies is not uncommon. Toothpick perforation of the cecum is rare both site wise and as an etiology of perforation involving the large intestine. We report a case involving a 65-year-old female whose presentation was with nausea, vomiting, and lower abdominal pain of 4 weeks duration. Clinical examination at presentation revealed tenderness in the right iliac fossa with peritonism. Blood results showed marginally elevated inflammatory markers. Computerized tomography (CT scan) of the abdomen and pelvis showed localized perforation of the cecum. Laparoscopy showed cecal perforation adjacent to the ileocecal valve; hence, a right hemicolectomy was performed. Histopathological examination confirmed the above finding. Foreign body perforation of large intestine, although rare, should be a differential for acute abdominal pain. A thorough history, examination, and pertinent imaging are vital to arrive at an early diagnosis and hence management plan.