Oesophageal perforation secondary to denture ingestion requiring thoracotomy and T-tube placement: a rare case report

Abstract

Oesophageal perforation from foreign body ingestion is a life-threatening emergency. Dentures pose particular risk due to irregular shape, size, and radiolucency. We present a 69-year-old female who accidentally ingested a denture. Radiography identified the foreign body at C4/C5. Endoscopic retrieval failed due to mucosal embedding, and a through-and-through oesophageal tear was confirmed. She underwent emergency right thoracotomy with denture retrieval. Given localized inflammation, a 4 cm perforation, and pneumomediastinum, a T-tube was placed across the defect instead of primary repair. Post-operatively, she required intensive care, enteral feeding, and prolonged chest drainage. Recovery was complicated by suspected mediastinitis, candidiasis, and deconditioning, but she ultimately tolerated oral intake and was discharged. In complex thoracic OP with inflammation or a large defect, T-tube placement offers a reliable, oesophagus-preserving alternative to primary repair. This case highlights the diagnostic challenges of radiolucent dentures and the importance of multidisciplinary decision-making.