
"Ethanol impairs consciousness and blunts protective reflexes (e.g., cough and gag), which disrupts the normal control mechanisms of the upper aerodigestive tract,"
"This reasoning leads to the search for an organic object that might be ingested while eating and drinking and is seemingly harmless but becomes invasive upon entering the gastrointestinal tract,"
"is a wooden toothpick-an object commonly found in club sandwiches and used for dental hygiene. Toothpick ingestions often go unnoticed, but once identified, they are considered medical emergencies owing to their propensity to cause visceral perforation and vascular injury."
Ethanol impairs consciousness and blunts protective reflexes such as cough and gag, disrupting control of the upper aerodigestive tract and increasing aspiration risk. Aspiration can introduce food and nonfood into the lungs while foreign objects are simultaneously ingested into the gastrointestinal tract during episodes of heavy drinking. Metallic or radiopaque items typically appear on imaging, whereas plant-derived and wooden objects do not. A swallowed wooden toothpick can go unnoticed yet migrate and cause visceral perforation and vascular injury. Duodenal perforation by a toothpick would explain concurrent pulmonary aspiration, abdominal injury, and systemic symptoms and requires urgent medical treatment.
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