Stabbing Pain in Chest – Doctor Finds Dental Brace in Gut – After 10 years in Bowel – Orthodontic Abdominal Piercing. A women in Australia could not remember having swallowed anything unusual but acute pains in her lower abdomen revealed the horrific consequences of an unknown ingestion over 10 years earlier (Report contains explicit medical photographs).
This week BMJ Case Reports (BMJ – formerly the British Medical Journal) published a report in which Dr Talia Shepherd described an unusual discovery in a female patient with severe abdominal pain.
Initially when the patient visited the hospital her medical adviser thought the problem was related to her gall bladder. They were able to alleviate the pain and send the woman home. She returned to the hospital two days later in absolute agony. The pain was so extreme that the doctor decided to give her a CT scan. This uncovered a long thin object which appeared to be embedded in her small intestine (see photo of CT scan).
Initially the physician thought this might be a fish bone – it had pierced the small bowel in several places causing the intestine to turn in on itself and prevented its normal movement – a condition known as Volvulus. If left untreated this can restrict blood flow to the area, eventually leading to the death and decay of this vital organ. A decision was made to open up the patient immediately to determine the exact cause of the damage and hopefully identify an appropriate course of action. The photo below shows what the medical team found when they opened up the woman’s abdomen (Medical photos: kind acknowledgements to BMJ Case Studies and Dr Talia Shepherd).
The piercing of the small intestine and the origin of the Volvulus was not a fish bone but a 7 cm piece of wire from an orthodontic brace.
What was particularly unusual about this finding was that it was 10 years since this 30 year old Australian lady had last worn a brace. She could not recall ever ingesting or losing part of her brace. The doctor assumed that the piece of metal had been sitting in the woman’s intestine for at least 10 years. It had only caused considerable pain recently, presumably when it pierced the woman’s small bowel.
It is very unusual for a piece of orthodontic brace to be swallowed and lead to serious problems in the gut. A few years ago doctors on Basel (Switzerland) identified what looked like a frog on the X-ray of a seven year old child’s throat. It turned out to be a frog shaped pendant that the child had swallowed and was removed by endoscopy under anaesthetic (see below for link to this and related X-ray pics).
This is the more usual condition of a brace after removal from a patient.
If you do swallow something that gives you cause for concern (or someone you knows does – like a child) seek medical advice as quickly as possible. Enjoy your lunch (but swallow carefully)!
Thanks Linda. The real issue for me here is how did the brace get into the lady’s gut in the first place? The medical report did not really provide much info on this (it was focused on encouraging doctors to use CT scans when faced with unexplained severe abdominal pains). The woman could not remember swallowing part of her brace but this is not something you would easily overlook (and her dentist should have noticed something missing during her next visit). Was she unconscious when it happened – perhaps a wild night…or maybe she was under anaesthetic? For me the most worrying scenario would be if an orthodontist accidentally ‘lost’ the piece of metal while the mouth was anaesthetised and either didn’t notice or decided not to say anything and hope for the best! Pure speculation of course! All the best, Chris.