Perforative Peritonitis Caused by Swallowing of a Complete Denture

A 91-year-old female with dementia visited the emergency department with complaint of a severe cough. A blood examination showed mild inflammation, and chest X-ray showed no infiltrative shadow (however, a complete denture which had been swallowed was detected at a future date : arrow in Figure 1). Therefore the patient was suspected of having upper respiratory inflammation and was prescribed an antibiotic. She was hospitalized after three days for fever, abdominal pain, and hypoxemia. A physical examination showed that her blood pressure, heart rate, axillary body temperature and oxygen saturation level were 110/57mmHg, 79 beats/min, 38.1°C, and 89% (oxygen mask 6L/min), respectively. An abdominal examination revealed rebound tenderness. Her white blood cell count was 9,000/mm3 and C-reactive protein level was 32.44mg/dl. During computerized tomography, the radiologist detected an extraintestinal saburra and a niveau in the abdominal cavity (Figure 2). This niveau had no relation with either the stomach or the colon. In addition, a complete denture (6.2 cm © 4.2 cm © 1.2 cm) was detected in the rectum (arrow in Figure 3). Based on all of the aforementioned clinical features, the patient was diagnosed to have perforative peritonitis caused by Figure 1.