case_images: PMC10904550_01
case_images: CT multiplanar reformation (MPR) (A,B) images showing that the toothpick in the distal rectal segment appears as a short linear hyperdense substance. One end is located in the left lateral wall of the rectum and penetrates the left levator ani muscle, while the other end penetrates the left internal obturator muscle. These two muscles are swollen with blurred surrounding fat. Axial T2WI (C) and DWI (D) of pelvic MRI reveals that there is a linear hypointensity in the left lateral wall of the lower rectum, consistent with the ingested toothpick, and the left levator ani and internal obturator muscles become thickened.
case_images: fsurg-11-1368762-g001.jpg
case_images: PMC10904550_01_fsurg-11-1368762-g001.jpg
case_images: F1
case_images: A pelvic computed tomography (CT) demonstrated that the left wall of the lower segment of the rectum approximately 6 cm above the anal verge was thickened, and a linear hyperdensity of 46 mm [CT value: 108-134 Hounsfield units (HU)] was detected outside the rectal wall, which was considered a foreign body (Figures 1A,B). T2-weighted imaging (T2WI) and diffusion-weighted imaging (DWI), with a linear low signal penetrating the rectal wall to the left internal obturator muscle (Figures 1C,D). The patient stated that he got drunk ten days ago.
case_images: A comparison of axial pelvic CT images before (A) and 12 days (B) after removing the toothpick from the lower rectum indicates that the swelling of the two muscles on the left side of the rectum becomes thinned and the inflammatory infiltration in the surrounding fat space disappears.
case_images: fsurg-11-1368762-g002.jpg
case_images: PMC10904550_01_fsurg-11-1368762-g002.jpg
case_images: F2
case_images: A follow-up pelvic CT revealed that the left levator ani muscle and the left internal obturator muscle became thin with measurements of 5 and 10 mm, respectively, with clear boundaries and a gap in the local mesorectal fat (Figure 2).