Accidental Ingestion of a 4-Unit-Bridge Removed by Gastroscopy in a Patient with Severe Motor and Intellectual Disabilities：A Case Report

Abstract

A 58-year-old man with mental retardation and cerebral palsy living in a nursing home accidentally swallowed a 4-unit-bridge #14-17. The bridge was found to be missing by one of the staff while performing oral hygiene care for the patient after lunch. Radiographic examination was immediately performed in order to locate the bridge. The X-ray showed the opacity of the bridge in the stomach. The bridge was immediately removed by endoscopy using a retrieval net and tip hood under intravenous anesthesia. No secondary mucosal damage occurred during removal. The ingested bridge was 35 mm long, weighed 8.3 g, and a 2.5-mm-long post screw for #14 was exposed. The bridge was a part of his 9-unit bridge for #17-#22, and had been cemented 2 years 8 months earlier. When an oral examination was performed in May 2013, the dentist pointed out slackness in the bridge, and the accidental ingestion occurred in July 2013.
It may be difficult to diagnose an ingested foreign body for a patient with severe motor and intellectual disabilities. To prevent accidental ingestion, a team of medical care practitioners plus periodic oral examination and daily oral hygiene care is considered to be important.