Emergency Esophagoscopy for Denture Impaction in an Adult with Pulmonary Atresia with Ventricular Septal Defect and Suspected Pneumonia: A Case Report

Abstract

Background : Esophageal denture impaction requires timely assessment because delayed removal can cause mucosal injury, perforation, and aspiration. Urgent intervention becomes more difficult when complex congenital cardiac anatomy, respiratory infection, and anticoagulation coexist. This report examines the perioperative challenges in a patient with pulmonary atresia with ventricular septal defect and suspected bacterial pneumonia who required emergency esophagoscopy.

Case Illustration :

A 51-year-old man developed throat pain and neck fullness after swallowing a denture. Cervical radiography showed an irregular opacity at C4–C5. His cardiac history included pulmonary atresia with ventricular septal defect, major aortopulmonary collateral arteries, patent ductus arteriosus, and moderate aortic regurgitation. Echocardiography reported a cardiac output of 2.9 L/min and a cardiac index of 1.86 L/min/m². Earlier chest imaging showed cardiomegaly and pulmonary edema, and the clinical assessment also identified suspected bacterial pneumonia. His recorded medications included furosemide, digoxin, lansoprazole, warfarin, bisoprolol, and spironolactone. Nebulized ipratropium and salbutamol were included in preoperative management.

Conclusion

This case illustrates the interaction between urgent foreign body management and complex congenital cardiac physiology. Perioperative assessment should integrate the pulmonary blood supply, cardiac reserve, respiratory disease, and anticoagulation exposure. Individualized multidisciplinary planning provides a coherent framework for balancing procedural urgency with cardiopulmonary and bleeding risks.