Aspirated tooth

Case contributed by Dr Henry Knipe

Presentation

Out-of-hospital VF arrest. Intubated.

Patient Data

Age: 60
Gender: Female
X-ray

 ETT projects 4.5 centimetres superiorly to the carina. 

Tooth (with an amalgam filling) projects over the bronchus intermedius, causing a degree of segmental collapse with increased opacity in the right lower zone. 

Left lung and both pleural spaces are clear. Cardiomediastinal contour is within normal limits.

Annotated image

Red circle highlights position of aspirated tooth. 

Case Discussion

Given the history (lack of trauma), the presumption would be that the tooth was dislodged during intubation. 

Dental injuries are rare, occuring most commonly during intubation (50%) followed by extubation (23%) with the maxillary incisors being the most at risk. 

Aspiration of a tooth will generally require bronchoscopy for removal. 

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Case information

rID: 25832
Case created: 11th Nov 2013
Last edited: 13th Jul 2017
System: Chest
Inclusion in quiz mode: Included

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