背景:义齿摄入或抽吸是一个问题,需要包括牙医在内的不同专家的认识,外科医生,耳鼻喉科医师,麻醉师等.在预防方面,早期诊断和适当治疗。吞食假牙的并发症包括中空内脏坏死,穿孔,穿透邻居器官导致瘘管,出血和阻塞。
方法:第一例是一名54岁的女性,在入院前约22小时跌倒时意外吞咽了可伸缩的单牙义齿,临床表现为急性小肠梗阻。病人做了剖腹手术,肠切开术与异物的检索。第二种情况是一名31岁的男性,他在进食时意外摄入了固定的单齿假体,影响了回肠瓣膜。在准备结肠镜检查期间,义齿自发地排出粪便。
结论:义齿摄入在精神神经缺陷患者中更为常见,酗酒和药物滥用者。在健康和年轻的人群中,很少摄入义齿。报告的两个患者都不是老年人。因此,可移动或固定义齿的移位是义齿摄入的另一个危险因素。义齿嵌塞最常见的部位是食道;小肠嵌塞很少见。此外,在大多数报告的案例中,摄入假牙的小肠嵌塞导致小肠穿孔。在我们的第一种情况下,摄入义齿的并发症似乎是肠梗阻,甚至更罕见。
结论:固定假牙和可移动假牙都可以意外摄入。义齿松动导致义齿意外摄入。建议义齿松动的患者尽快去看牙医。
BACKGROUND: Denture ingestion or aspiration is a problem requiring awareness of different specialists including dentists, surgeons, otolaryngologists, anesthesiologists etc. in terms of prevention, early diagnosis and adequate treatment. Complications of swallowed dentures include hollow viscus necrosis, perforation, penetration to neighbor organs leading to fistulae, bleeding and obstruction.
METHODS: First case is a 54-year-old female who accidentally swallowed retractable one-tooth denture during fall about 22 h before admission and clinical manifestation of acute small bowel obstruction developed. The patient underwent laparotomy, enterotomy with retrieval of the foreign body. The second case is a 31-year-old male who accidentally ingested fixed one-tooth prosthesis while eating which impacted in the ileocaecal valve. During the preparation to colonoscopy the denture spontaneously passed out with stools.
CONCLUSIONS: Denture ingestion is more common among patients with psychoneurologic deficit, alcohol and drug abusers. Among healthy and younger population denture ingestion is rare. Both reported patients are not elder. Thus dislodgement of removable or fixed dentures is another risk factor of denture ingestion. Most common site of denture impaction is esophagus; small bowel impaction is rare. Moreover, in most reported cases, small bowel impaction of ingested dentures leads to small bowel perforation. In our first case the complication of denture ingestion appeared to be bowel obstruction what is even rarer.
CONCLUSIONS: Fixed dentures can be accidentally ingested as well as removable dentures. Denture loosening leads to accidental denture ingestion. Patients with denture loosening should be recommended to visit dentist as soon as possible.