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      Swallowed dentures: Two cases and a review

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          Abstract

          Introduction

          Denture ingestion or aspiration is a problem requiring awareness of different specialists including dentists, surgeons, otolaryngologists, anesthesiologists etc. in terms of prevention, early diagnosis and adequate treatment. Complications of swallowed dentures include hollow viscus necrosis, perforation, penetration to neighbor organs leading to fistulae, bleeding and obstruction.

          Presentation of cases

          First case is a 54-year-old female who accidentally swallowed retractable one-tooth denture during fall about 22 h before admission and clinical manifestation of acute small bowel obstruction developed. The patient underwent laparotomy, enterotomy with retrieval of the foreign body. The second case is a 31-year-old male who accidentally ingested fixed one-tooth prosthesis while eating which impacted in the ileocaecal valve. During the preparation to colonoscopy the denture spontaneously passed out with stools.

          Discussion

          Denture ingestion is more common among patients with psychoneurologic deficit, alcohol and drug abusers. Among healthy and younger population denture ingestion is rare. Both reported patients are not elder. Thus dislodgement of removable or fixed dentures is another risk factor of denture ingestion. Most common site of denture impaction is esophagus; small bowel impaction is rare. Moreover, in most reported cases, small bowel impaction of ingested dentures leads to small bowel perforation. In our first case the complication of denture ingestion appeared to be bowel obstruction what is even rarer.

          Conclusion

          Fixed dentures can be accidentally ingested as well as removable dentures. Denture loosening leads to accidental denture ingestion. Patients with denture loosening should be recommended to visit dentist as soon as possible.

          Highlights

          • Denture ingestion or aspiration is a multidisciplinary problem.

          • Fixed dentures are also at high risk of ingestion or aspiration in case of their spontaneous or traumatic dislodgement.

          • Clinical presentation of denture ingestion is very different depending on the site of impaction and complications.

          • Patients with loose dentures should visit dentist as early as possible.

          Related collections

          Most cited references40

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          Foreign-body ingestion in children: experience with 1,265 cases.

          This study aims to elucidate the clinical presentation, the effectiveness of investigations, and treatment of foreign body ingestion in children and to formulate an algorithm of management. The records of children admitted to a single institution who had a history of foreign body ingestion over 33 years were reviewed. Symptoms, radiological findings, and endoscopic findings were assessed. Foreign bodies were detected in 552 (43%) of the 1,265 children admitted. The age of the children ranged from 6 months to 16 years (mean, 5.2 years). The preschool toddlers (mean age, 3.8 years) were most prone to ingest inanimate objects. The most common objects were coins (49%) and nonmetallic sharp objects (NMSO; 31%). Although x-rays could detect all the metallic objects and 86% of glass objects, the sensitivity of fish bone detection is only 26%. Absence of symptoms was common (50% in metallic group and 29% in NMSO group). Forty-one percent of coins and 95% of NMSO were lodged at sites suitable for removal by direct laryngoscopy alone with success rates of 86% and 77%, respectively. There were 3 disease-related complications and 1 mortality. Two of these children were mentally retarded and presented late. Efforts for prevention of ingestion of inanimate foreign body should focus on the preschool toddler group. Particular attention should be paid to mentally retarded children with vague gastrointestinal symptoms. Absence of symptoms does not preclude presence of foreign body in children. Children with history of NMSO ingestion should undergo direct laryngoscopy despite negative radiological finding, both as a screening procedure or treatment.
            • Record: found
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            Foreign body in the oesophagus: review of 2394 cases.

            A total of 2394 patients with a foreign body in the oesophagus was treated in our unit between 1965 and 1976, including 343 children in whom fish bones (146) and coins (134) were most commonly responsible; in adults, bones (fish and chicken) were commonest. Most of the foreign bodies were impacted in the cervical oesophagus. Pharyngoscopy and oesophagoscopy were carried out under general anaesthesia in all cases except those in which the foreign body was ejected spontaneously or when the patient refused the examination. Oesophageal perforation due to a foreign body was encountered in only one child. Two patients in the series developed the fearsome complication of oesophagoaortic fistula.
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              Management of ingested foreign objects and food bolus impactions.

              G Ginsberg (1994)
              This review article is intended to aid the clinician in the evaluation and management of older children and adult patients with possible foreign object ingestion and/or food bolus impaction. A literature search was performed in June 1993 on the Medline using Medlars II, the National Library of Medicine's National Interactive Retrieval Service. This search generated 181 citations. References chosen for review were English-language citations from the gastroenterology, otolaryngology, general surgical, and radiological literature. As little or no data exist from well-designed prospective trials, emphasis was given to results from large series. In preparing this manuscript several drafts were distributed to the members of the American Society for Gastrointestinal Endoscopy, Standards of Practice Committee, and to national experts on the subject for critical review.

                Author and article information

                Contributors
                Journal
                Ann Med Surg (Lond)
                Ann Med Surg (Lond)
                Annals of Medicine and Surgery
                Elsevier
                2049-0801
                22 October 2015
                December 2015
                22 October 2015
                : 4
                : 4
                : 407-413
                Affiliations
                [a ]Department of Abdominal Surgery, Vladimir City Clinical Hospital of Emergency Medicine, Vladimir, Russia
                [b ]Diamant Dental Clinic, Vladimir, Russia
                [c ]Department of Otorhinolaryngology, Vladimir Oblast Clinical Hospital, Vladimir, Russia
                [d ]Anesthesiology Department, Vladimir City Clinical Hospital of Emergency Medicine, Vladimir, Russia
                Author notes
                []Corresponding author. gachabayovmahir@ 123456gmail.com
                Article
                S2049-0801(15)00107-7
                10.1016/j.amsu.2015.10.008
                4637341
                26635957
                7da7b2ad-6b84-4064-9472-35265c202dff
                © 2015 The Authors

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 20 August 2015
                : 8 October 2015
                : 10 October 2015
                Categories
                Review

                denture ingestion,denture aspiration,swallowed denture,foreign bodies of gastrointestinal tract,small bowel obstruction

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