Unfolding a mystery: a case of small bowel perforation in an edentulous patient

A small bowel perforation caused by ingestion of plant stems or herbal twigs is rare, with inherent diagnostic challenges (i.e. secondary to radiological translucency and nonspecific manifestations). This is a 50 years-old male, who is edentulous and habitually drinks tea using Ocimum every evening, presented to the emergency department with lower-quadrants abdominal pain for 1 day with no prior history of an animal meat-based meal (e.g. fish, chicken). The labs revealed minimal leucocytosis, and the abdominal computed tomography showed a hyperdense linear foreign body penetrating through the terminal ileum. The patient was stable and underwent bowel resection and anastomosis with an uneventful post-operative course. Therefore, even in edentulous patients with no foreign bodies (e.g. bones, toothpicks) possibly ingested, herbs might be a rare cause worthy of investigation.