Scheduled for surgery? Don't forget to take your dentures out.
They got stuck in his throat - and were only discovered eight days later.
The initial surgery was to remove a harmless lump in the man's abdominal wall. But because of the denture debacle, he suffered pain, bleeding and swallowing difficulties, and endured repeated hospital visits, additional invasive tests and blood transfusions.
He also required two additional operations.
The presence of any false teeth or dental plates in-patients should be clearly documented before and after any surgery, said Dr. Harriet Cunniffe, lead author of a case study on the elderly patient's ordeal. Cunniffe is an ear, nose and throat specialist with James Paget University Hospitals NHS Foundation Trust in Great Yarmouth, England.
According to the report, six days after his surgery, the man went to the emergency department. But doctors there concluded that the bleeding in his mouth, swallowing difficulties and pain were due to a respiratory infection and side effects from having a tube down his throat during surgery.
He was prescribed mouthwash, antibiotics and steroids, and sent home.
Two days later, he returned to the emergency department with worsening symptoms. He told doctors he hadn't been able to swallow any of his prescribed medicines.
At this point, he was re-admitted to the hospital. Tests revealed a semi-circular object lying across his vocal cords, which had caused internal swelling and blistering.
When told this, the man said his dentures - a metal roof plate and three false teeth - were lost during his previous hospital stay for his abdominal surgery.
Doctors operated to remove the dentures and kept him hospitalized for six days. However, he returned a number of times over the next few weeks because of bleeding. Doctors eventually determined that the bleeding was due to internal wound tissue around the blistering caused by his false teeth. They cauterized the tissue to prevent further bleeding.
But by this time the patient had lost so much blood that he required a blood transfusion.
After another two days in the hospital, he was sent home.
But the hospital still hadn't seen the last of him. He returned nine days later with more bleeding caused by a torn artery in the wound. Emergency surgery was ordered.
Over the next six weeks, however, his tissue healed, he did not require any more emergency care, and his blood count returned to normal, according to the Aug. 12 BMJ Case Reports.
This isn't the first documented case of dentures being inhaled while a patient is under general anesthetic, the authors noted.
In the United Kingdom, "there are no set national guidelines on how dentures should be managed during anesthesia," the authors wrote in a journal news release.
"It is known that leaving dentures in during bag-mask ventilation allows for a better seal during induction (when the anesthetic is being infused), and therefore many hospitals allow dentures to be removed immediately before intubation [when a tube is inserted into the airway to assist breathing]," they wrote.
However, all members of the surgical team need to know what's to be done with a patient's dentures, Cunniffe and her colleagues said.
- Robert Preidt.