TU1.6 Endoscopic Management of Broncho-Oesophageal Fistula Caused by Impacted Denture

Abstract

Background Oesophageal foreign body impaction in adults is fairly common. Although, dentures being often accidentally ingested among the elderly, it is very unusual to develop a broncho-oesophageal fistula (BOF) secondary to a retained denture. The few cases reported in the literature were mostly managed with thoracotomy. We present a clinical case of a BOF successfully treated by endoscopic approach following a combined assessment and planning between intervention radiology, general and cardiothoracic surgery. Case Report A 60-year-old male was transferred from neighbouring DGH to our centre due to worsening of dysphagia. Patient reported that he had swallowed a denture 6 month earlier. The CT scan showed the denture along with a left BOF. Imaging was further reviewed and discussed amongst interventional radiology, cardiothoracic, and upper gastrointestinal surgeons. Endoscopic retrieval of impacted denture plate was successful, followed by the insertion of left bronchial stent, and percutaneous gastrostomy tube. The left bronchial stent was removed after three months with successful closure of the fistula. Conclusion Our clinical case highlights that multidisciplinary team discussion is crucial in the management of complex surgical cases in order to achieve the best outcome possible. Additionally, endoscopic management of BOF is a safe alternative option to thoracotomy when the required resources are available.