Article
Surgical retrieval of a swallowed denture in a schizophrenic patient
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Published: | April 21, 2016 |
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Background: Accidental foreign body ingestion is a common phenomenon in children between 6 months to 6 years of age. In adults, foreign body ingestion is commonly observed in the geriatric population and in patients with psychiatric disorders. Besides food bolus, fish and chicken bones, dentures represent the most commonly ingested foreign bodies in the adult population. Over 80% of ingested foreign bodies pass uneventfully through the intestinal tract. Endoscopic retrieval is needed in about 20% while surgical intervention is indicated in less than 1%.
Materials and methods: Herein we present a case of accidental ingestion of a dental prosthesis. The patient had accidentally swallowed one of his dental prosthesis while eating. He was referred to our department following two unsuccessful endoscopic retrieval attempts.
Results: A chest x-ray showed the denture projected to the cervical esophagus. A pneumomediastinum and other local complications were excluded on computed tomography. Endoscopic examination revealed an impaction of the dental prosthesis with penetration into the esophageal mucosa. The denture was retrieved following a longitudinal incision of the esophagus via a left cervical approach. The postoperative course was complicated by an esophageocutaneous fistula which was managed conservatively.
Conclusion: Surgical intervention is required in less than 1% of cases for the management of ingested foreign bodies. Surgery is indicated following the failure of endoscopic intervention or to address complications.
Although most ingested foreign bodies can be endoscopically retrieved, surgery still has its justification in the management of patients with ingested foreign bodies.