Sigmoid colon perforation caused by ingested removable dentures: A case report and literature review

吞入活动义齿导致乙状结肠穿孔:病例报告及文献综述

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Abstract

RATIONALE: Ingestion of removable dentures leading to gastrointestinal perforation is a rare but potentially life-threatening emergency, particularly in the elderly population due to diminished oral sensation and swallowing reflex. This article reports the management of a patient who developed sigmoid colon necrosis and perforation. PATIENT CONCERNS: A 76-year-old female presented to the emergency department with a 2-day history of nausea and left lower abdominal pain. Medical history collection confirmed that the patient had accidentally swallowed her removable denture 3 days ago. DIAGNOSES: Abdominal computed tomography identified a high-density foreign body in the sigmoid colon and pneumoperitoneum with dilated bowel loops. Combined with the medical history, the diagnosis of sigmoid colon perforation caused by ingested dentures was confirmed. INTERVENTIONS: Emergency treatment involved Hartmann procedure for resection of the necrotic bowel segment and colostomy. Four months later, laparoscopic-assisted stoma reversal was successfully performed to restore intestinal continuity. OUTCOMES: The patient recovered uneventfully and was discharged without complications. Hartmann procedure is an effective and safe treatment for colonic perforation that needs emergency treatment and cannot be anastomozed in 1 stage. LESSONS: Early identification and individualized treatment are critical for patients with ingested dentures. Denture restoration for high-risk groups should be reconsidered or replaced with safer alternatives.

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