Denture Aspiration within Trachea during Seizure

A 44-year-old man with a past history of refractory status epilepticus was admitted to our Emergency Department two days after a tonic-clonic seizure with a subsequent foreign body swallowing sensation. He reported mild shortness of breath, odynophagia, and hemoptysis. On examination, his respiratory rate and oxyhemoglobin saturation (SaO₂) was in a normal range. No foreign body was found in an initial examination using a nasopharyngoscope, but the posteroanterior and lateral chest radiography detected the presence of a denture-shaped foreign body in the distal trachea, just above the carina (Figure 1A–B). A thoracic computed tomography scan confirmed the foreign body location and showed no pneumomediastinum or any other associate complication (Figure 1C). The patient was taken to the operating room for a rigid bronchoscopy. The patient was intubated. A denture was found in the distal trachea. The foreign body was extracted with forceps in a two-stage procedure (Figure 1D), because during the last step of extraction, the denture was blocked in the narrow glottic area. After the foreign body extraction, the patient was extubated. Immediately after extubation, the patient developed hemoptysis. The patient was reintubated and topical epinephrine was rinstilled for hemostasis to shrink the swollen mucosa. Bleeding stopped and final revision of the trachea showed a mild mucosal laceration in the distal trachea. No tracheal perforation was found. Repeat chest radiography was normal and the patient was later discharged home without complications.