S4225 Early Removal of Impacted Partial Dentures to Avoid Esophageal Perforation With Normal Radiography

Introduction: Dentures are used for cosmetic purposes and to restore the function of missing teeth. Accidentally swallowed dentures can lead to severe complications in the gastrointestinal tract. Therefore, early detection and effective therapeutic management are important. We are reporting a case of accidentally swallowed partial dentures with normal x-ray. Case Description/Methods: A 66-year-old woman with past medical history of pre-diabetes, hypertension, hyperlipidemia presented with complaint of accidentally swallowing partial denture while taking her pills 2 hours ago complaining of severe pain in the chest. Patient denies any drooling of saliva, cough, vomiting or choking sensation. The patient described the denture as thumb size with 1 artificial tooth on it but no metal in the prosthesis. Vitals are normal. Eelectrocardiogram is normal. Chest and neck soft tissue x-rays are read as within normal limits. Patient is in no respiratory distress. Patient received glucagon in the emergency department with no relief of chest pain. Even though there are no symptoms of esophageal obstruction and no radiological abnormalities, we performed emergency endoscopy with high suspicion of complicated impacted foreign body. Emergency upper endoscopy performed within 4 hours of accidental ingestion of foreign body. Endoscopy showed impacted partial denture which is got stuck to the esophageal wall of mid esophagus and on manipulation with Rat- toothed forceps the denture got dislodged into the lumen and later it is carefully extracted outside. On post-removal examination there is deep eroded wall of the esophagus which would have perforated if left for longer duration. Later the patient was discharged home in a stable condition. Discussion: The partial dentures can get impacted into the walls of the esophagus and can cause severe complications if left for long time and normal radiographic imaging cannot rule out impending complications with radio non-opaque foreign body. It is always recommended to do an emergency endoscopy and early removal of dentures to avoid severe complications as in this patient.