Ingestion and inhalation of dental instruments can be life threatening and should be managed cautiously, with early input from general surgeons, gastroenterologists, or respiratory physicians for possible endoscopic retrieval, emergent laparotomy, or surgical intervention. The patient was discharged after a final radiograph confirmed the absence of the foreign body. During this time, the patient did not demonstrate any clinical signs of bowel perforation, nor was there any radiographic evidence of pneumoperitonium. On admission, plain abdominal radiographs confirmed the position of the file in the duodenum, and serial radiographs were used to monitor its transition and clearance through the gastrointestinal tract. He had experienced two episodes of excessive coughing and dyspnea while undergoing endodontic therapy, and was promptly referred by his dentist for further investigation. Case reportĪ 62-year-old Caucasian male presented to the Emergency Department approximately 2 hours after suspected ingestion or inhalation of an endodontic hand file. We conclude by describing methods for surveillance and management of ingested dental instruments. Plain radiographs were used to identify its location, and serial imaging was used to monitor passage of the endodontic file through the gastrointestinal tract, and it ultimately passed without intervention. Here we describe a case in which an endodontic hand file was accidentally misplaced in situ during endodontic (root canal) therapy. Ingestion of dental instruments is rare during dental surgery but can result in serious complications.
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