Denture aspiration in facial trauma, the nightmare comes true
Brief clinical details (80 words):
This 16-year-old girl fell from 5-floor height. On arrival, she was comatose. Other vital signs were blood pressure 76/43 mmHg, heart rate 140 beats/min, respiration 16 breaths/min. Physical examination was remarkable for swollen face with lacerations on lower lip and chin, right ear bleeding, right knee laceration, and open fracture of both legs. Resuscitation was done following the ATLS guidelines.
Description of the relevant abnormalities (80 words):
A tooth-shape radio-opaque could be identified at the junction between the chest and abdomen on the chest X-ray after endotracheal intubation. The exact location was later confirmed to be in the stomach by computed tomography.
Why this image is clinically or educationally relevant? (50 words)
Risk of teeth aspiration is real in patients sustaining major maxillofacial trauma. Detection can be difficult, especially in patients with impaired consciousness or in extreme ages. Secure the airway first if there is any respiratory symptom or sign. Teeth aspiration can only be excluded after adequate imaging examinations.
