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The pancreas, an elongated and flat gland situated behind the stomach, serves a vital function in digesting food and managing blood sugar levels.
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Peach pit impaction presenting as gallstone ileus.

Abdus Samad Syed1, Alexander Bonte1, Laith Adnan Allaham1

  • 1Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA.

BMJ Case Reports
|July 30, 2020
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Summary
This summary is machine-generated.

A rare case of small bowel obstruction (SBO) was caused by a peach pit. This highlights the importance of considering fruit pits in the differential diagnosis of bowel obstruction, even when imaging suggests gallstone ileus.

Keywords:
gastrointestinal surgeryradiology

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Area of Science:

  • Gastroenterology
  • Surgical Pathology

Background:

  • Small bowel obstruction (SBO) is a common surgical emergency.
  • Obstruction due to foreign bodies is infrequent, with gallstone ileus being a more common consideration for intraluminal masses.
  • Fruit pit impaction is an exceptionally rare cause of SBO.

Observation:

  • A 56-year-old male presented with symptoms of SBO, including abdominal pain and vomiting.
  • Radiological imaging revealed a large, stony mass in the terminal ileum, mimicking a gallstone.
  • The mass was characterized by a hypodense center and a hyperdense, ridged outer layer.

Findings:

  • The impacted mass was surgically removed via enterotomy.
  • The object was identified as a peach pit, measuring 3.3 cm.
  • The pit caused a high-grade partial SBO.

Implications:

  • This case underscores the necessity of including fruit pit impaction in the differential diagnosis of SBO, particularly when imaging findings are suggestive of gallstone ileus.
  • Accurate diagnosis can prevent delays in treatment and potential complications.
  • Awareness among clinicians can improve patient outcomes in rare obstructive scenarios.