False teeth must be removed before major surgery, doctors have warned, after a pensioner swallowed his dentures and did not notice for more than a week.
The 72-year-old married electrician underwent an operation to remove a harmless lump in his abdominal wall at James Paget University Hospital in Great Yarmouth earlier this year.
However, six days later he returned to the emergency department complaining of blood in his mouth, swallowing difficulties and pain, which prevented him from eating solid food.
Doctors at first assumed he was simply suffering the after-effects of having a tube inserted into his throat during surgery, and sent him home with mouthwash, antibiotics and steroids.
But, two days later, he visited A&E with worsening symptoms - unable to swallow any of the medicine he was admitted with suspected pneumonia.
X-rays showed he had a semi-circular object lying across his vocal chords, which had caused internal swelling and blistering.
The patient then disclosed that his dentures, which consisted of a metal roof plate and three false teeth, had been lost during his original hospital stay.
Writing in the BMJ Case Reports, its authors said there were no national guidelines for dealing with the problem and warned it was not the first instance of dentures being inhaled while anaesthetic is being administered.
“This case is important as it highlights a number of key learning points for anaesthetists, theatre staff, emergency physicians and ear, nose and throat (ENT) surgeons alike,” said the report authors.
Full or partial dentures are worn by approximately one in five people aged between 18 and 74 years old.
In 2016, the University of Aberdeen carried out a review of swallowed dentures, looking back 15 years, and discovered 83 reports from 23 countries. Six of the cases had happened in surgery during a general anaesthetic.
In the latest case the man was taken for emergency surgery to remove the false teeth and discharged after six days in hospital.
However, a bout of bleeding forced him to return once more six days later, followed by a second visit 10 days after that, and a third six days after being discharged again.
Tests showed he had suffered an internal wound tissue around the site of the blistering which doctors then treated by cauterising it to prevent further bleeding. The man also required a blood transfusion.
Nine days after he was discharged once more, he returned with further bleeding which required emergency surgery as the source of the bleed was a torn artery in the wound.
The authors say doctors should clearly document the presence of false teeth both before and after a procedure, with all members of the surgical team made aware of what is to be done with them.