Successful esophagotomy after failed attempts of esophagoscopic retrieval of impacted denture

Abstract

Ingested foreign bodies, although fairly common among children, can present in individuals of all age. Most common risk factors for such cases in adults include psychiatric illness, alcohol abuse and ill-fitting dentures. Most of the ingested foreign bodies pass through the gastrointestinal tract but intervention maybe required in case of impaction, obstruction or perforation. Foreign bodies mostly tend to get impacted at anatomical constrictions like cricopharyngeus, aortic arch and lower esophageal sphincter. We present a rare case of impacted denture in esophagus which could not be retrieved despite multiple esophagoscopic retrieval attempts leading to removal by successful esophagotomy. Investigations including X-ray and rigid esophagoscopy confirmed the presence of denture with its hooks impacted in the esophageal wall at the level of C6-C7 vertebra. Majority of the foreign bodies can be removed by flexible endoscopy or esophagoscopy but due to its impaction in esophageal wall these techniques were unsuccessful. Therefore, multidisciplinary team decided to opt for an esophagotomy with transcervical approach. Successful esophagotomy was performed with the retrieval of sharp hook like body. Our case underscores the importance of early surgical intervention in case of failed attempt to remove the foreign body through minimally invasive techniques to prevent complications in form of perforation and mediastinitis.