A case of duodenal perforation caused by a partial denture in a patient with mental retardation

Abstract

A 49-year-old man with mental retardation admitted to our hospital because of abdominal pain. Physical examination showed high-grade fever tenderness of the abdomen. An abdominal radiograph showed a foreign body in the left side. Abdominal computed tomography showed a foreign body in the small intestine and free air and fluid collection in the retroperitoneal space around the duodenum. We asked his caretakers detailed questions about the foreign body and diagnosed duodenal perforation due to a partial denture. We performed an emergent operation for the removal of the partial denture and closure of the duodenal perforation. The presence of a foreign body should be specified before deciding the therapeutic plan. However, it is difficult to ask detailed symptoms to patients with mental retardation. Therefore, careful physical examination and effective communication to with the family and caretakers of these patients is important.