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A 17 year old woman presented to the emergency room after accidental ingestion of a toothbrush. The patient tearfully admitted that she had been self inducing vomiting to control her weight for the past 8 months. Four hours prior her admission and after a copious lunch, she used her toothbrush to induce vomiting and unintentionally swallowed it. After the accident, she noted chest pain and an intractable cough, which had resolved spontaneously by the time she reached the hospital. Plain chest radiography was performed and showed the toothbrush in the stomach (fig 1A). Gastroscopy was performed and the toothbrush was grasped with a polypectomy snare and withdrawn without complications (fig 1B).
Long ingested objects (longer than 60–100 mm) are unlikely to pass the duodenal sweep and should be removed. The accidental ingestion of the toothbrush in this case revealed an underlying serious eating disorder.
Competing interests: there are no competing interests.
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