Bladder Foreign Body of Gastrointestinal Origin: A Case Report and Literature Review.

BACKGROUND

Gastrointestinal-origin urinary foreign bodies are rare and often overlooked, particularly because early Computed Tomography (CT) scans may be inconclusive, especially in cases involving wooden materials.

CASE PRESENTATION: A 19-year-old man presented with lower-abdominal pain and gross hematuria one week after accidentally ingesting a toothpick. Initial local CT scans were negative. At our center, bedside ultrasonography revealed a linear hyperechoic tract crossing the bladder wall, while thin-slice non-contrast CT only detected a punctate hyperdensity at the bladder dome. Cystoscopy confirmed the presence of a wooden toothpick partially penetrating the bladder; ureteroscopic extraction successfully removed the intact 6-cm toothpick, followed by an uneventful recovery.

CONCLUSIONS

A detailed ingestion history along with thin-slice non-contrast CT and high-frequency ultrasonography can help identify subtle wooden foreign bodies. These diagnostic tools should prompt early cystoscopy, and selective gastrointestinal endoscopy is warranted when suspicion remains high. Endoscopic removal is preferred, with escalation reserved for cases of complex extraluminal migration.