Swallowed dental prosthesis causing late oesophageal obstruction and tracheo-oesophageal fistula in a young patient

A 25-year-old man presented to the emergency department after a rugby accident having swallowed a dental plate. Initial assessment at the time of ingestion, including a chest radiograph, was unremarkable and the plate was presumed to have been expectorated. Five years later he presented with progressive dysphagia, recurrent food bolus obstruction, and haemoptysis. Computed tomography of the thorax performed 5 years later revealed circumferential oesophageal thickening and a large inflammatory mass around a retained radio-opaque foreign body at the level of the carina, with an associated tracheo-oesophageal fistula. Endoscopy confirmed near-complete obstruction of the oesophagus. He underwent a right thoracotomy with oesophagectomy, removal of the retained dental prosthesis and repair of the fistula. He made a slow but steady recovery and has required anastomotic dilatation for a stricture. This case highlights the risk of complications from retained oesophageal foreign bodies and the limitations of plain radiography in detecting non-radio-opaque dental plates.