Oesophageal perforation as a complication of ingested partial denture

Abstract

We report herein the case of a 53-year-old female who came to the emergency room with the chief complaints of severe dysphagia and chest pain following accidental swallowing of her denture. The patient had swelling of the face, neck and eyelids with difficulty in breathing. A skull radiograph was taken, which revealed a missing partial denture from the right lower jaw. Anteroposterior radiograph of the chest showed two metallic objects in the mid-thorax, adjacent to the descending aorta. CT scan of the neck and chest revealed two metallic objects (measuring approximately 17mm each) in the middle one-third of the oesophagus (right posterolateral aspect), causing perforation of the oesophagus and leading to pneumomediastinum, and left pneumothorax with subcutaneous emphysema of the neck and chest. An emergency thoracoscopic removal of the foreign body (partial denture) was performed with subsequent repair of the oesophageal tear in the same sitting. Post surgery, the patient was shifted to intensive care unit and she recovered well over a course of time. In summary, accidental ingestion of a partial denture can lead to grave complications such as oesophageal perforation, which should be managed on an emergency basis with thoracoscopic removal of the foreign body.

Lost Denture Found in Esophagus After a Decade: A Rare Case Report

“…In adults, it is mostly observed in the elderly population and psychiatric individuals [3,4]. In children, coins and button batteries are the commonly ingested foreign bodies, whereas, in adults, dentures are most common [1,5]. This is because dentures cause a gradual loss of sensation of the oral cavity and laryngopharynx.…”

“…The management strategies for the removal of the esophageal foreign body include endoscopic removal and surgery. Attempts at endoscopic removal of the impacted dentures may cause intramural perforation or a full-thickness tear owing to the possible entrapment of wire hooks in the esophageal wall [1]. Therefore, surgery remains a safe and effective treatment for patients with impacted dentures in the esophagus.…”

“…Accidental ingestion of foreign bodies is commonly seen in the extremes of age group (children and elderly). Dentures, meat boluses, and fish bones are the most commonly ingested foreign bodies in the elderly population [1]. Once a foreign body has passed beyond the cricopharynx, it frequently gets lodged in the esophagus because it has weak peristalsis and multiple anatomical narrowings [1,2].…”

“…Dentures, meat boluses, and fish bones are the most commonly ingested foreign bodies in the elderly population [1]. Once a foreign body has passed beyond the cricopharynx, it frequently gets lodged in the esophagus because it has weak peristalsis and multiple anatomical narrowings [1,2]. Longstanding impaction might lead to mucosal ulceration, perforation, sepsis, and death [2].…”