[Perforation of the cecum by a toothpick--a rare differential acute appendicitis diagnosis. Case report and review of the literature].

We report the case of a 46-year-old man who was admitted to the medical department of the hospital Reichenbach with a 2-day history of central and upper abdominal pain. The pain was displaced in the right lower abdominal quadrant, which is why the patient was transferred to our department. At laparoscopy a toothpick was found perforating the cecum. Laparoscopic management, therapeutic possibilities and problems of diagnosis are discussed. The patient does not recall having ingested a toothpick. The laparoscopic treatment of perforation of the cecum by a toothpick might be among the rarest operations ever conducted. In the literature no such publication could be found up to now.