Jejunal Perforation Caused by Accidental Denture Swallowing: A Case Report

Accidental denture ingestion, though rare, is a serious cause of acute abdomen. While most swallowed dentures pass through without complications, some can become impacted, leading to potentially severe complications. Diagnosis is challenging due to the radiolucent nature of dentures. We present a rare case of denture impaction in the jejunum, resulting in intestinal obstruction and perforation. A 70-year-old male presented with diffuse abdominal pain, vomiting, and constipation after accidentally swallowing part of his dentures 10 days earlier. The patient sought medical advice three and five days before the current presentation, during which multiple non-contrast CT scans were performed and demonstrated the presence of dentures within the small bowel without evidence of obstruction or perforation. However, a subsequent contrast-enhanced CT scan revealed jejunal dilatation, a hyperdense structure, and a small bowel feces sign, consistent with mechanical obstruction. The hyperdense structure was identified as the metallic component of the ingested denture. Emergency laparotomy revealed jejunal perforations, and jejunal resection with end-to-end anastomosis was performed. The patient recovered well and was discharged after seven days. Foreign body ingestion can occur in both children and adults, with fish bones, bones, and dentures being commonly swallowed by adults. Dentures, made of radiolucent materials, can be challenging to detect on plain radiographs, necessitating high clinical suspicion and the use of CT scans for accurate diagnosis. While denture impaction is more common in the esophagus or large bowel, cases in the small bowel are extremely rare. Complications such as perforation can occur, especially within a week, if the foreign body does not pass spontaneously. Conservative management is initially recommended, but surgical intervention may be necessary, particularly for lower gastrointestinal tract foreign bodies. Elderly patients with acute abdominal symptoms and denture ingestion history should be suspected of complications. A high index of suspicion and prompt contrast-enhanced CT are crucial. Surgical intervention should not be delayed for impacted lower GI tract foreign bodies to prevent life-threatening complications like perforation.