This case report details the accidental death of an elderly gentleman who was a passenger in a motor vehicle accident, the cause and mechanism of death being determined as cardiac tamponade due to a traumatic laceration of the ventricle. The forensic autopsy revealed as an adjunct finding a mechanical trauma to the descending colon, being a perforation of a colon diverticulum due to an ingested toothpick. The historical aspects of toothpicks, risk factors associated with the accidental ingestion of toothpicks and different clinical presentations associated with ingestion and peristaltic migration of toothpicks as a foreign body are discussed.
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