One of the most common and distressing emergencies a gastroenterologist faces is food or a foreign object becoming stuck, or "impacted," in the esophagus. This is especially prevalent in the elderly, where issues with chewing or swallowing can lead to serious complications. When the impacted object is a partial denture with sharp edges, the situation becomes even more delicate and urgent.
This case study from our Bilaspur clinic, handled by Dr. Sitendu Kumar Patel, illustrates the precision and skill required to safely manage such a scenario using advanced, minimally invasive endoscopic techniques.
Table of Contents
The Presenting Problem: A Frightening Inability to Swallow
An elderly gentleman was brought to the emergency room in Bilaspur in significant distress. While eating, he had accidentally swallowed his small partial denture. He was now unable to swallow anything—not even his own saliva—and was experiencing significant chest pain and discomfort.
An urgent X-ray confirmed that the denture was lodged tightly in his mid-esophagus.
The Danger of Esophageal Impaction
When an object gets stuck in the esophagus, it is a medical emergency. The constant pressure on the esophageal wall can disrupt blood flow, leading to tissue death (necrosis). Sharp objects, like the metal clasps on a denture, pose a high risk of:
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Laceration: Tearing the lining of the esophagus.
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Perforation: Creating a hole through the esophageal wall, a life-threatening complication that can lead to severe infection in the chest cavity.
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Airway Obstruction: If the object is high up, it can compress the windpipe.
Immediate removal is essential to prevent these severe outcomes.
The Challenge: A Large, Sharp Object in a Sensitive Area
Dr. Sitendu Kumar Patel was consulted for the emergency procedure. The case presented a unique set of challenges:
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The Patient's Age: Elderly patients often have other medical conditions that must be carefully managed during sedation.
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The Object's Shape: The denture was not smooth. Its irregular shape and sharp metal clasps made it difficult to grasp and increased the risk of injuring the esophagus during removal.
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The Impaction: The denture was tightly wedged, and simply pulling it could cause a tear.
The Solution: A Meticulous and Gentle Emergency Endoscopy
The patient was taken for an urgent
Upper GI Endoscopy
. This procedure was the only safe, non-surgical option for removal.
The Diagnostic Phase: Assessing the Situation
Under sedation, Dr. Patel carefully advanced the endoscope to the point of impaction. The high-definition camera provided a clear view of the denture, its orientation, and how it was embedded in the esophageal tissue. This initial assessment was crucial for planning a safe retrieval strategy.
The Therapeutic Phase: Careful Retrieval
Using a specialized retrieval tool known as a Roth Net—a small, strong net that can be deployed through the endoscope—Dr. Patel was able to carefully maneuver the net around and underneath the denture. Once the denture was securely encased within the net, the sharp edges were covered, protecting the esophageal lining. With slow, gentle traction, the endoscope, net, and denture were withdrawn as a single unit.
The Outcome: Immediate Relief and Prevention of Injury
The denture was removed successfully and in one piece. A subsequent pass with the endoscope confirmed that, thanks to the careful technique, there was no significant injury, tearing, or perforation to the esophageal wall. The patient felt immediate relief and, after a period of observation, was able to resume drinking liquids and was eventually discharged home safely.
A Common but Serious Problem in the Elderly
This case highlights a frequent issue among older adults, especially those who wear partial dentures. A reduced sense of feeling in the palate can make it easy to accidentally swallow a denture along with food. It is a powerful reminder for caregivers to be aware of this risk.
The Importance of Specialized Endoscopic Skill in Bilaspur
Successfully removing a large, sharp, impacted foreign body is a test of an endoscopist's skill, patience, and judgment. It requires not only knowledge of standard procedures but also the ability to adapt and use a variety of specialized retrieval tools.
Having a gastroenterologist like Dr. Sitendu Kumar Patel with expertise in advanced therapeutic endoscopy available in Bilaspur is critical. It ensures that patients in Bilaspur and across Chhattisgarh have access to prompt, safe, and effective non-surgical solutions for complex and urgent problems.
Frequently Asked Questions (FAQ) About Swallowed Objects
What are the signs that food or an object is stuck in the esophagus?
The most common signs are a sudden inability to swallow (dysphagia), chest pain or pressure, excessive drooling, and regurgitating undigested food.
Should I try to drink water to push it down?
No. If an object is truly impacted, drinking liquids can cause them to back up and be aspirated into the lungs. It can also make a subsequent endoscopic procedure more difficult. Seek immediate medical attention.
What happens if a stuck object is not removed?
The risks are severe and increase with time. They include perforation of the esophagus, severe infection, and tissue death. It is always considered a medical emergency.
