Cunniffe Harriet A
East of England Deanery, UK.
BMJ Case Rep. 2019 Aug 12;12(8):e230055. doi: 10.1136/bcr-2019-230055.
An active 72-year-old man presented to the accident and emergency department (A&E) with odynophagia, dysphagia and haemoptysis 6 days after a minor operation and was discharged after treatment for an aspiration pneumonia. He presented to A&E 2 days later with worsening symptoms and was found to have dentures lodged in his larynx which were then removed in theatre. For 6 weeks after removal, he had periodic episodes of frank haemoptysis requiring multiple blood transfusions and, after extensive investigation, was found to have an erosion into an arterial vessel on his right parapharyngeal wall, just posterior to the glossopharyngeal sulcus. This case raises questions about perioperative care in patients with dentures, diagnostic decision-making in the emergency care setting and postoperative care after delayed removal of foreign bodies from the upper aerodigestive tract.
一名72岁的活跃男性在一次小手术后6天因吞咽疼痛、吞咽困难和咯血就诊于急诊科,经治疗吸入性肺炎后出院。两天后,他因症状加重再次就诊于急诊科,发现假牙嵌顿在喉部,随后在手术室取出。取出假牙后的6周内,他定期出现大量咯血,需要多次输血,经过广泛检查,发现其右咽旁壁、舌咽沟后方的动脉血管有一处糜烂。该病例引发了关于佩戴假牙患者的围手术期护理、急诊环境中的诊断决策以及上呼吸道消化道异物延迟取出后的术后护理等问题。