Cherry-Pit Perforation of an Ileocecal Diverticulum: A Case Report

Seed-induced colonic perforation is exceptionally rare but may mimic malignancy or complicated diverticulitis, leading to diagnostic challenges. We report the case of a middle-aged man who presented with acute right lower quadrant abdominal pain. Contrast-enhanced computed tomography (CT) revealed mural thickening and a target-like lesion at the ileocecal junction, raising suspicion for intussusception or carcinoma. Emergency surgery identified a cherry pit perforating a pseudodiverticulum in the ileocecal region. This case highlights the potential for hard fruit seeds to cause full-thickness bowel injury, especially in right-sided pseudodiverticula, which are more prevalent in Asian populations and lack a protective muscularis layer. Characteristic imaging features, such as hyperdense intraluminal objects with surrounding inflammation, can assist in differentiating these cases from neoplastic or inflammatory conditions. Taking a detailed dietary history and carefully reviewing CT scans using bone window settings can facilitate early diagnosis. Clinicians should remain aware of this rare but serious entity, as prompt surgical intervention is crucial in the presence of perforation or generalized peritonitis.