Fatal small bowel perforation caused by an impacted dental prosthesis in an elderly neurologically impaired woman.
Tijana Gojković, Veljko Milošević, Milenko Bogdanović et al.
✦ AI-curated · Sources linked
Case in brief
A 60-year-old woman with significant neurological impairment was admitted unconscious and later died from purulent peritonitis due to small bowel perforation caused by an impacted lower partial denture. Initial abdominal radiography showed no significant findings. Postmortem examination revealed a 3-mm perforation in the terminal ileum and marked adhesions, with the denture found at the perforation site, highlighting the challenges in diagnosing such cases in neurologically impaired patients.
What made this case unusual
The case illustrates a rare instance of gastrointestinal perforation due to an impacted dental prosthesis, particularly in a patient with significant neurological impairment, complicating the clinical presentation.
Diagnostic / clinical pearl
Clinicians should be aware that plain abdominal radiography may not detect foreign bodies, especially in patients with neurological impairments, where symptoms may be subtle or absent.
Why it matters
This case underscores the importance of thorough evaluation and consideration of foreign body ingestion in patients with swallowing difficulties, particularly in the elderly and neurologically compromised populations.