From mouth to misfortune: esophageal perforation by a prosthetic tooth fragment. A case report

Adriana M. Guajardo-Montemayor, Service of General Surgery, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Mexico
Jorge A. Gutierrez-González, Service of General Surgery, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Mexico
Carlos Pacheco-Molina, Service of General Surgery, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Mexico
Dario E. Medina-Muñoz, Service of General Surgery, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Mexico
Gerardo E. Muñoz-Maldonado, Service of General Surgery, Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Mexico
Andrea M. Guillen-Graf, Service of Gastroenterology. Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Mexico
Joel O. Jáquez-Quintana, Gastroenterology Service, Universidad Autónoma de Nuevo León, School of Medicine and University Hospital “Dr. José E. González”, Monterrey, Nuevo Leon, Mexico
Luis A. Gonzalez-Torres, Service of Gastroenterology. Hospital Universitario Dr. José Eleuterio González, Universidad Autónoma de Nuevo León, Monterrey, Mexico

Foreign body ingestion is a common clinical problem, particularly in older adults with predisposing factors such as edentulism, psychiatric conditions, or neurological impairment. The ingestion of sharp-pointed objects, including dental prostheses, poses a significant risk of esophageal injury and perforation. Our case depicts the importance of multidisciplinary management, including gastroenterology, radiology, and surgery teams. This case report presents dental prosthesis ingestion with an uncommon evolution. A 64-year-old female accidentally swallowed a fragment of her dental prosthesis, leading to esophageal mucosal damage and suspected perforation. Radiographic imaging revealed a radiolucent object at the cervical esophagus and an incidental finding of situs inversus. Endoscopy confirmed mucosal ulceration and edema. Due to high suspicion of perforation, surgical intervention via cervicotomy and primary repair was performed. The patient had a favorable recovery without complications. This case emphasizes the importance of early recognition, appropriate imaging, and a multidisciplinary approach when managing high-risk foreign bodies in the upper gastrointestinal tract.

Keywords: Esophageal perforation. Foreign body. Dental prosthesis. Diagnostic endoscopy. Cervicotomy. Elderly patient.