Surgical outcome of impacted artificial denture in esophagus

Abstract

Introduction and objective

Foreign body getting lodged in esophagus is quite common, commonly due to ingestion of coin, pin, fish bone and meat. But accidental ingestion of artificial denture is a less often found condition. This paper studies the etiology, management, complications and final outcome of denture obstructing the esophagus.

Material and methods

Fourteen patients with denture esophagus were reviewed retrospectively, admitted between Jan 2012 to Oct 2016. The clinical presentations, cause of the denture ingestion, radiological findings, surgical intervention, complication and final outcome were studied. Most common site of impaction is crico pharynx junction. Denture was removed by cervical incision in all cases. Post-operatively ryles tube was kept routinely in all patients and gastrograffin swallow was performed. After mandatory follow up of one year, patients were followed as and when needed.

Results

All the patients presented with complaint of difficulty in swallowing. Five of them also had pain in neck and fever. Cause of denture ingestion was found to be very old denture, fitted by quacks, which they did not change for years. Hence they get loose and accidentally got ingested during sleeping or with the meal. Intra-operatively posterior esophageal wall ruptured in 3 cases for which repair was performed. All patients had severe periesophagitis. Post-operatively 3 patients developed esophagocutaneous fistula. Post-operative stricture was not seen in any case.

Conclusion

Early surgical intervention is must to prevent complications. Sharp metallic wires in esophagus prevent their endoscopic removal. They should be regularly changed, before they get loose. Denture implants should be done by qualified dentists only.