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

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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.

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Data availability

The authors confirm that they had full access to all the data in the study and take full responsibility for the integrity of the data and the accuracy of the data analysis.

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Authors and Affiliations

  1. Department of Radiology, University of California-San Diego Medical Center, 200 West Arbor Drive, San Diego, CA, 92103, USA

    Gary G. Ghahremani & Katherine M. Richman

Authors
  1. Gary G. Ghahremani
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  2. Katherine M. Richman
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Contributions

All authors have contributed to this work and read and approved the final manuscript.

Corresponding author

Correspondence to Gary G. Ghahremani.

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Conflict of interest

The authors declare that they have no conflict of interest.

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Highlights

• Toothbrush may be swallowed on accidental or intentional basis.

• Either the broken head or entire toothbrush can be ingested.

• The radiopaque wires holding the nylon bristled make it visible on radiographs.

• This series of 8 cases is the largest recorded in the literature.

• In 4 patients, the toothbrushes were lodged in the duodenum or colon without causing a perforation.

• All were removed by endoscopic or surgical intervention because spontaneous passage per rectum does not occur.

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Ghahremani, G.G., Richman, K.M. Accidental or intentional ingestion of toothbrushes: experience with 8 adult patients. Emerg Radiol 29, 377–382 (2022). https://doi.org/10.1007/s10140-021-02009-x

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  • DOI: https://doi.org/10.1007/s10140-021-02009-x

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