Perianal abscess and fistula caused by toothpick ingestion three years before... an unexpected discovery!

Gastrointestinal tract (GIT) foreign body (FB) ingestion is a significant clinical problem. Most of the times, the ingested body will pass through the gastrointestinal (GI) tract uneventfully or it will impact in the appendix, cecum or in the terminal ileum. The anal canal is an unusual site of FB impaction. Toothpick perforations of the gastrointestinal tract are uncommon, but they are associated with a high mortality rate of 20% to 80%. The most common site of injury is the duodenum followed by the sigmoid colon and ileum. We report the case of a man with a 3-years history of perianal abscess and fistula caused by a toothpick ingested three years before.