Skip to main content
Top
Published in: Patient Safety in Surgery 1/2017

Open Access 01-12-2017 | Case report

Surgical retrieval of a swallowed denture in a schizophrenic patient: a case report

Authors: Johannes Dörner, Herbert Spelter, Hubert Zirngibl, Peter C. Ambe

Published in: Patient Safety in Surgery | Issue 1/2017

Login to get access

Abstract

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. 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%. Herein we report an extremely rare case of esophagocutaneous fistula following operative retrival of an impacted denture in the esophagus with spontaneous healing within 3 weeks. A similar case to the best of our knowledge has so far not been reported previously.

Case presentation

A case of accidental ingestion of a dental prosthesis in a 35-year old schizophrenic patient is presented. The patient was referred to our department after accidentally swallowing one of his dental prosthesis. Surgical retrieval was indicated after two unsuccessful endoscopic retrieval attempts. The denture was retrieved following a longitudinal incision of the esophagus via a left cervical approach. The postoperative course was complicated by a clinically suspected esophagocutaneous fistula which was managed conservatively via nothing per os with enteral feeding via a nasogastric tube. Secretion ceased 3 weeks later and a fistula could not be found on contrast enhanced radiographic examination with gastrographin®.

Conclusion

Esophagocutaneous fistula represents a rare but serious complication following foreign body ingestion. An interdisciplinary management including an early surgical consultation should be considered in patients with foreign body impaction in the esophagus following failure of endoscopic retrieval.
Literature
1.
2.
go back to reference Sung SH, Jeon SW, Son HS, Kim SK, Jung MK, Cho CM, Tak WY, Kweon YO. Factors predictive of risk for complications in patients with oesophageal foreign bodies. Dig Liver Dis. 2011;43(8):632–5.CrossRefPubMed Sung SH, Jeon SW, Son HS, Kim SK, Jung MK, Cho CM, Tak WY, Kweon YO. Factors predictive of risk for complications in patients with oesophageal foreign bodies. Dig Liver Dis. 2011;43(8):632–5.CrossRefPubMed
3.
go back to reference Mosca S, Manes G, Martino R, Amitrano L, Bottino V, Bove A, Camera A, De Nucci C, Di Costanzo G, Guardascione M, et al. Endoscopic management of foreign bodies in the upper gastrointestinal tract: report on a series of 414 adult patients. Endoscopy. 2001;33(8):692–6.CrossRefPubMed Mosca S, Manes G, Martino R, Amitrano L, Bottino V, Bove A, Camera A, De Nucci C, Di Costanzo G, Guardascione M, et al. Endoscopic management of foreign bodies in the upper gastrointestinal tract: report on a series of 414 adult patients. Endoscopy. 2001;33(8):692–6.CrossRefPubMed
4.
go back to reference Webb WA. Management of foreign bodies of the upper gastrointestinal tract: update. Gastrointest Endosc. 1995;41(1):39–51.CrossRefPubMed Webb WA. Management of foreign bodies of the upper gastrointestinal tract: update. Gastrointest Endosc. 1995;41(1):39–51.CrossRefPubMed
5.
go back to reference Ginsberg GG. Management of ingested foreign objects and food bolus impactions. Gastrointest Endosc. 1995;41(1):33–8.CrossRefPubMed Ginsberg GG. Management of ingested foreign objects and food bolus impactions. Gastrointest Endosc. 1995;41(1):33–8.CrossRefPubMed
6.
go back to reference Hong KH, Kim YJ, Kim JH, Chun SW, Kim HM, Cho JH. Risk factors for complications associated with upper gastrointestinal foreign bodies. World J Gastroenterol: WJG. 2015;21(26):8125.CrossRefPubMedPubMedCentral Hong KH, Kim YJ, Kim JH, Chun SW, Kim HM, Cho JH. Risk factors for complications associated with upper gastrointestinal foreign bodies. World J Gastroenterol: WJG. 2015;21(26):8125.CrossRefPubMedPubMedCentral
7.
go back to reference Peng A, Li Y, Xiao Z, Wu W. Study of clinical treatment of esophageal foreign body-induced esophageal perforation with lethal complications. Eur Arch Otorhinolaryngol. 2012;269(9):2027–36.CrossRefPubMed Peng A, Li Y, Xiao Z, Wu W. Study of clinical treatment of esophageal foreign body-induced esophageal perforation with lethal complications. Eur Arch Otorhinolaryngol. 2012;269(9):2027–36.CrossRefPubMed
8.
go back to reference Bertoni G, Sassatelli R, Conigliaro R, Bedogni G. A simple latex protector hood for safe endoscopic removal of sharp-pointed gastroesophageal foreign bodies. Gastrointest Endosc. 1996;44(4):458–61.CrossRefPubMed Bertoni G, Sassatelli R, Conigliaro R, Bedogni G. A simple latex protector hood for safe endoscopic removal of sharp-pointed gastroesophageal foreign bodies. Gastrointest Endosc. 1996;44(4):458–61.CrossRefPubMed
9.
go back to reference Ikenberry SO, Jue TL, Anderson MA, Appalaneni V, Banerjee S, Ben-Menachem T, Decker GA, Fanelli RD, Fisher LR, Fukami N, et al. Management of ingested foreign bodies and food impactions. Gastrointest Endosc. 2011;73(6):1085–91.CrossRefPubMed Ikenberry SO, Jue TL, Anderson MA, Appalaneni V, Banerjee S, Ben-Menachem T, Decker GA, Fanelli RD, Fisher LR, Fukami N, et al. Management of ingested foreign bodies and food impactions. Gastrointest Endosc. 2011;73(6):1085–91.CrossRefPubMed
Metadata
Title
Surgical retrieval of a swallowed denture in a schizophrenic patient: a case report
Authors
Johannes Dörner
Herbert Spelter
Hubert Zirngibl
Peter C. Ambe
Publication date
01-12-2017
Publisher
BioMed Central
Published in
Patient Safety in Surgery / Issue 1/2017
Electronic ISSN: 1754-9493
DOI
https://doi.org/10.1186/s13037-017-0147-8

Other articles of this Issue 1/2017

Patient Safety in Surgery 1/2017 Go to the issue