Delayed Presentation of Oesophageal Perforation from Dental Prosthesis
- Author:
Wan Nurul Fathihah Mohamad ZAFIRI
;
Mohamad Masykurin MAFAUZY
;
Wan Nur Shazwani Wan ROSSLY
;
Afifah Sjamun SJAHID
;
Mohd Hafizuddin HUSIN
- Publication Type:Case Report
- Keywords:
Oesophageal perforation;
Foreign bodies;
Sepsis;
Mediastinitis;
Hydropneumothorax;
Dental prosthesis
- From:
Brunei International Medical Journal
2026;22():74-77
- CountryBrunei Darussalam
- Language:English
-
Abstract:
Dental prosthesis ingestion in adults is uncommon, and delayed presentation may complicate diagnosis and management. We report a 39 -year-old woman with epilepsy who accidentally ingested a broken dental prosthesis during sleep. She initially presented with a foreign body sensation and underwent laryngoscopy and oesophagogastroduodenoscopy 24 hours after ingestion and these were unremarkable with no foreign body identified. Four days later, she developed dyspnoea, chest pain, and sepsis. Clinical and radiological assessments revealed a massive left pleural effusion, pneumomediastinum, and contrast leakage from the distal oesophagus, consistent with an oesophageal perforation. The patient was referred urgently for surgical intervention and was successfully treated. This case illustrates the diagnostic challenges of radiolucent dental prostheses and the potential for mucosal injury that may not be immediately evident, which can lead to delayed diagnosis or misdiagnosis resulting in severe complications. Awareness and early recognition, appropriate imaging with computed tomography or contrast studies, and high clinical suspicion are critical, particularly in neurologically compromised patients. Prompt diagnosis and intervention are essential to prevent serious complications such as mediastinitis, sepsis, and respiratory failure
