# Endoscopic management of ingested toothpick resulting in duodeno-ureteric fistula

## TL;DR

A 57-year-old patient developed a rare duodeno-ureteric fistula from an ingested toothpick, successfully treated via endoscopic removal.

## Contribution

Presents a novel case of endoscopic management for a toothpick-induced fistula between the duodenum and renal pelvis.

## Key findings

- Toothpick ingestion can lead to duodeno-ureteric fistula causing recurrent urosepsis.
- Endoscopic removal effectively resolved the infection and fistula in this case.

## Abstract

Toothpicks are commonly used but rarely ingested. Unlike most foreign bodies, if accidentally swallowed these rarely spontaneously pass. The duodenum has been reported as the most common site of toothpick foreign body lodgement in the upper gastrointestinal tract. We report the case of a 57-year-old presenting with recurrent urosepsis after non recognition of a toothpick impaction in the duodenum with fistulisation into the right renal pelvis. Endoscopic removal of the foreign body was successful in management of the urosepsis.