Archiv für August 2006

How to amputate a leg with a toothpick

August 08, 2006 - Markus Hoenicka
I've mentioned ingested toothpicks as a cause of serious problems previously, but things can turn out far worse. In another case reported by the New England Journal of Medicine the toothpick ultimatively led to the loss of a leg, due to a series of complications and coincidences.

A 60-year old patient presented to the hospital complaining about rectal bleeding, pain in one of his legs, and an episode of fainting. A thorough medical examination confirmed bleeding in the colon as well as a lack of vascular flow in the affected leg. Upon performing a laparotomy (simply put, they opened the belly for visual inspection) the surgeons found a toothpick which got stuck at a sharp turn of the colon. Incidentally, this turn was right next to the external iliac artery (one of the arteries which delivers blood to the leg) which was perforated after the toothpick pierced a hole into the colon wall. Due to the increased risk of an infection (it is not a good idea to place a graft on the artery if the contents of your colon has spread right there...) the surgeons were not able to perform a revascularization at the affected site. This eventually led to the amputation of the lower leg due to gangrene, followed by an amputation above-the-knee a few days later due to wound healing problems.

Now if you must use toothpicks and ingest one every now and then, please choose models made from metal which can be located radiographically. It'll make it so much easier for your doctor to find out what's wrong, and it might even save you a leg.