# Successful Endoscopic Removal and Closure of a Large Esophageal Perforation Following Accidental Ingestion of a Dental Prosthesis

## TL;DR

A large esophageal perforation caused by a swallowed dental prosthesis was successfully treated using endoscopic techniques, avoiding major surgery.

## Contribution

Demonstrates a novel dual-endoscope and OTSC-based approach for safely removing and repairing large esophageal perforations.

## Key findings

- A dental prosthesis lodged in the thoracic esophagus was successfully removed using dual endoscopes.
- A large esophageal perforation was effectively closed using an OTSC and Mantis clips.
- Follow-up confirmed complete healing of the perforation without the need for invasive surgery.

## Abstract

Endoscopic removal of accidentally ingested dental prostheses can be challenging as their irregular shapes can occasionally cause severe complications, such as gastrointestinal perforation. Here, we present the case of an older woman who was referred to our hospital following accidental ingestion of a bridge‐type denture. Computed tomography revealed that the denture was lodged in the thoracic esophagus, with concurrent mediastinal emphysema. Endoscopic examination confirmed that the denture had penetrated the esophageal wall. Under general anesthesia, the denture was endoscopically removed using dual endoscopes, and a large esophageal perforation was closed with an over‐the‐scope clip (OTSC) and subsequently reinforced with Mantis clips. Although follow‐up endoscopy 1 month later demonstrated remaining OTSC at the site of the esophageal perforation, 3‐month follow‐up endoscopy confirmed complete closure of the perforation. Overall, this case indicates the usefulness of the dual‐endoscope approach for foreign‐object removal and the OTSC system for closure of esophageal perforations, thus providing the chance of avoiding invasive treatment such as esophagectomy.