Abstract: Foreign body ingestion leading to visits to the emergency department is more frequent in the pediatric age group. Most ingested objects are passed out in the stools. However, ingestion of pointed objects could result in severe complications. Our case is a 93-year-old woman who presented with abdominal wall cellulitis and abscess confirmed on computed tomographic scan. Bedside drainage revealed an intact toothpick. Cultures grew intestinal organisms including Bacteroides fragilis, confirming the presence of an enterocutaneous fistula. Laparotomy for surgical excision of the fistula was deemed very high risk, and the patient opted for conservative management. One year later, she is in complete recovery.