Abstract
A 90-year-old man admitted to our hospital complaining of high fever (38°C) was diagnosed with pneumonia by a chest and abdominal computed tomography (CT) scan. Although the high fever and pneumonia quickly resolved with antibiotic therapy, high fever (39°C) recurred 9 days after the admission. Whilst there was no abdominal pain nor signs of peritonitis, a second abdominal CT scan revealed intraperitoneal free air and a high density of foreign body at the ileo-cecal region. A comparison with the first CT taken at the admission revealed that the foreign body had moved from the left lower abdominal cavity to the ileocecal region over the 9 days. An intraoral inspection revealed that his artificial tooth was lost. Intestinal perforation caused by an accidentally ingested artificial tooth was diagnosed, and an emergent laparoscopy assisted surgery was performed. The laparoscopy showed an ileal perforation of 7 mm in diameter located about 10 cm orally from the Bauhin valve. Ileo-cecal resection was performed and the artificial tooth in the shape of a protruding claw was found in the cecum of the resected specimen. No serious postoperative complications occurred but his difficulty in swallowing persisted, and he was transferred to a nursing hospital 39 days postoperatively for rehabilitation.
