Rectal Foreign Body Due to Accidental Ingestion of Denture Fragments in an Elderly Patient

老年患者因意外吞食假牙碎片导致直肠异物

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Abstract

Foreign body ingestion is an important yet often overlooked cause of gastrointestinal symptoms in elderly patients, particularly those wearing dentures. Atypical presentations due to reduced visceral pain sensitivity and cognitive impairment may delay recognition and increase complication risk. A man in his late 80s presented with two weeks of lower abdominal pain. He had diabetes mellitus, angina pectoris, chronic obstructive pulmonary disease, and hypothyroidism, and no history of gastrointestinal surgery or prior swallowing incidents. Physical examination showed mild lower abdominal tenderness without peritoneal signs. CT demonstrated a high-attenuation linear structure in the rectosigmoid region with surrounding fat stranding. Given his comorbidities and surgical risk, colonoscopic retrieval was performed, and an approximately 5 cm denture fragment was removed without perforation. He recovered uneventfully and was discharged on day 6. Foreign body ingestion in elderly patients often involves dental prostheses. Prior reports frequently required surgery due to perforation, whereas early CT diagnosis and careful endoscopic removal can enable minimally invasive management, even in rectosigmoid cases. Although endoscopic success rates are high in aggregate, lower gastrointestinal cases remain rare. In elderly denture wearers with unexplained abdominal pain, accidental ingestion should be considered early. CT imaging and denture inspection can facilitate prompt diagnosis. When feasible, minimally invasive endoscopic retrieval may avoid surgery and achieve favorable outcomes in selected high-risk patients.

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