A 65-year-old woman presented with 1 week of epigastric pain and inability to eat but no fever. Ultrasound and CT scans detected a foreign body in her portal vein that was originating from her gastric antrum wall, causing portal vein thrombosis. Blood tests confirmed an infection. The diagnosis was a toothpick that had penetrated her gastric wall and entered her liver through her left portal vein branch. Treatment would involve removing the foreign body via open laparotomy.