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胸腔镜取出上胸段食管内嵌顿的义齿

Thoracoscopic removal of dental prosthesis impacted in the upper thoracic esophagus.

机构信息

Department of Biomedical Sciences for Health, Division of General Surgery, University of Milano Medical School, IRCCS Policlinico San Donato, Via Morandi 30, 20097, San Donato Milanese, (Milano), Italy.

出版信息

World J Emerg Surg. 2014 Jan 14;9(1):5. doi: 10.1186/1749-7922-9-5.

Abstract

Dental appliances are the most common cause of accidental foreign body esophageal impaction, especially in the elderly population with decreased oral sensory perception. A 47-year-old man with history of oligophrenia and recurrent epileptic seizures was referred to our hospital following dislocation and ingestion of his upper dental prosthesis. Endoscopic removal and clipping of an esophageal tear had been unsuccessfully attempted. A chest CT scan confirmed entrapment of the dental prosthesis in the upper thoracic esophagus, the presence of pneumomediastinum, and the close proximity of one of the metal clasps of the prosthesis to the left subclavian artery. A video-assisted right thoracoscopy in the left lateral decubitus position was performed and the foreign body was successfully removed. The patient was then allowed to wear the retrieved prosthesis after dentistry consultation and repair of the wire clasps by a dental technician. At the 6-month follow-up visit the patient was doing very well without any trouble in swallowing.

摘要

牙科器械是最常见的导致意外食管异物嵌顿的原因,尤其是在口腔感觉减退的老年人群中。一名 47 岁男子,有精神发育迟滞和复发性癫痫发作病史,其上部义齿脱位并被误吞后被转至我院。内镜下已尝试过取出并夹断义齿,但未成功。胸部 CT 扫描证实义齿嵌顿在上胸段食管,纵隔积气,且义齿的一个金属卡环与左锁骨下动脉非常接近。取左侧卧位行视频辅助右侧胸腔镜检查,成功取出异物。随后,在牙科医生会诊和修复了义齿的金属卡环后,患者被允许佩戴取出的义齿。6 个月随访时,患者吞咽功能良好,无任何不适。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2ea0/3896804/f8fbfa843633/1749-7922-9-5-1.jpg

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