Duodenal obstruction due to accidental swallowing of a dental prosthesis: a case report and review of the literature

Abstract

Background Artificial dentures are the most common object ingested by elderly patients and account for 4–18% of all foreign body ingestions. Denture impaction in the small bowel is a rare phenomenon. Surgery of the duodenum is difficult, so endoscopy should be the first choice in these patients. There are very rare case reports on denture ingestion-induced duodenal obstruction or perforation, so the aim of this publication was to show a rare case of accidental ingestion of a dental prosthesis with duodenal obstruction and also perforation that could not be treated with endoscopic management and was managed with duodenal kocherization and gastrostomy. Case presentation A 47-year-old Iranian woman presented to our hospital with epigastric abdominal pain of 2 hours’ duration after the accidental ingestion of a dental prosthesis 2 days before admission. The patient had severe epigastric tenderness. Radiographic examination revealed nothing. Upper gastrointestinal endoscopy showed a swallowed lodged denture in the second to third parts of the duodenum, and the attempt to extract the denture failed. The patient underwent laparotomy and duodenal kocherization, pushing the denture to the stomach, and gastrostomy, and the denture was brought out without any complications. Conclusions Patients with old and worn dentures should have their prosthesis reconstructed and redesigned periodically in order to prevent denture ingestion and its complications. Early surgical intervention is recommended in patients with failed endoscopic extraction of foreign bodies and in those with duodenal perforation.

A case of accidental ingestion of a hooked denture without symptoms for 6 years

“…It is tempting to assume that dentures with hooks are more likely to damage the gastrointestinal tract, but there were two reports that showed no statistical relationship between denture shape and the risk of perforation or penetration [ 3 , 4 ]. The duration from accidental denture ingestion to perforation or penetration of the lower gastrointestinal tract ranges from 1 day to 6 months [ 5 , 6 ]. Considering these references, regardless of the shape of the denture, there is a risk of gastrointestinal perforation or penetration if dentures are accidentally swallowed and reach the lower gastrointestinal tract.…”

Colonic Perforation: A Case Report of a Rare Delayed Complication Due to Accidental Swallowing of Denture

“…The passage through the alimentary canal depends on the diameter as well as the length of the ingested foreign body [ 1 ]. A recent review by Kent et al concluded that all shapes (hooked or unhooked) of dentures carry equal risk of complications like perforation once impacted [ 4 ].…”

“…Artificial teeth in the form of crowns, dental implants, or removable dentures are extremely common. Removable partial dentures account for 4% to 18 % of foreign body ingestion and are the most commonly found object found in elderly patients [ 1 ]. Impaction of these ingested dentures can occur anywhere along the alimentary canal but is most commonly found in the esophagus followed by the large bowel [ 2 ].…”

Multimodal minimally invasive management of retained impacted denture in duodenum

“…Duodenal retained dentures are best dealt with endoscopy first. [ 3 ] Moreover, as the denture would cause more traumas while being removed through that route, a combined procedure using laparoscopy was anticipated and planned. Minimally invasive combined laparoscopy and endoscopic management of this patient helped the faster recovery of this patient and with minimal post-operative morbidity.…”

“…Even when reported to have caused complications in the duodenum, the management is difficult as if they cannot be removed endoscopically, then it resulted in laparotomy, kocherisation of the duodenum and enterotomy. [ 3 ]…”