Corpus Alienum Esophagus (Denture) with Proximal Esophageal Perforation Complications

Abstract

Introduction: The corpus alienum of the esophagus had to be diagnosed quickly and extracted to prevent further complications. The magnitude of complications is dependent on the type and diameter of the corpus alienum as well as the method and duration of the extraction procedure from the time of ingestion. One of the complications of the corpus alienum of the esophagus is esophageal perforation. Appropriate management is needed to make clinical improvement of patients who swallowed the corpus alienum esophagus with complications of esophageal perforation. Case Illustration: A 54-year-old male patient with a history of swallowing dentures for the previous 3 days and complaining of dysphagia when swallowing water or eating solid food. Odynophagia is felt constantly. The patient has been using dentures for 3 years, the patient's dentures consist of 2 front teeth with braces. Vital signs were within normal limits and there were no signs of dehydration. Tactile tenderness is in the anterior cervical region on laryngeal movement, and subcutaneous emphysema is minimal. The results of AP-Lateral chest X-ray, corpus alienum (confirmed dentures) impression on the CV C7 esophagus, and soft tissue swelling with subcutis emphysema. The patient was diagnosed with a corpus alienum esophagus (denture) as high as CV C7. The patient was given antibiotics and anti-inflammatory then performed an esophagoscopy procedure which when entering the esophageal lumen, the corpus alienum (denture) was 17 cm high from the incisors. After post-extraction evaluation, a perforation was found in the length of approximately 4 cm in the proximal tracheal esophagus, then the wound was closed (5 sutures) in the perforation area and a nasogastric tube number 16 was placed. The patient was given antibiotic therapy, anti-pain, anti-inflammatory, PPI, and liquid diet via nasogastric tube. On the 22nd day of post-extraction evaluation, from the clinical and radiological picture, it was found that the perforation had closed tightly. Sutures were removed, a nasogastric tube was removed and the patient was able to eat and drink orally. Conclusion: Esophagoscopy is an appropriate procedure for extracting the corpus alienum (denture) of the esophagus, although it causes complications of perforation due to the large, rigid, and sharp dimensions of the corpus alienum. Esophageal perforation can be treated with the insertion of a nasogastric tube for a liquid diet and with oral antibiotic and PPI therapy.