Читать книгу Management of Complications in Oral and Maxillofacial Surgery - Группа авторов - Страница 93

Ingestion of a dental implant or implant component can pose several concerns. Due to their small size, implants and components are smaller than coins, and usually do not become lodged in the esophagus; most often, they are found in the stomach on radiographs and then move on through the digestive tract without incident; most of the time (90%), the ingested foreign object passes through the gastrointestinal (GI) tract without complications, and they also rarely become lodged at the ileocecal valve. About 10% of the time, an endoscopic retrieval may be required if the implant does not move completely through the GI tract spontaneously. Although most data show that small and blunt objects pass through the GI tract uneventfully, it is estimated that in 1% of cases a GI surgical procedure is required to retrieve an ingested object [29]. A conservative approach to this complication should include a clinical abdominal examination, obtaining abdominal X‐rays, and timely stool inspection for documentation that the implant has passed. Perforation within the GI tract is rare, but more likely to occur with sharp foreign objects, and this warrants a referral to a gastroenterologist for an early open or endoscopic assessment of the GI tract and removal of the object. Surgical intervention is recommended if the object has not passed spontaneously, has been present for >2 weeks, or if the patient becomes symptomatic with abdominal pain or rebound tenderness, guarding, nausea, or vomiting [29]. Such cases require a prompt referral to a gastroenterologist for diagnosis and management.