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Un tallo de planta afilado que causa perforación del íleon terminal con presentación clínica similar a apendicitis
Pirada Yincharoen1, Weeratian Tawanwongsri2
1Department of Surgery, School of Medicine, Walailak University, Nakhon Si Thammarat, Thailand.
Frontiers in medicine
|December 15, 2025
Resumen
La ingestión de material vegetal puede causar perforación del intestino delgado, imitando la apendicitis. Un reporte de caso detalla un fragmento de madera de *Gnetum gnemon* que causa perforación ileal, destacando las limitaciones de las imágenes.
Área de la Ciencia:
- Gastroenterología
- Patología Quirúrgica
- Imágenes Médicas
Sus antecedentes:
- La ingestión de material vegetal es una causa poco común de perforación del intestino delgado.
- La presentación clínica puede imitar la apendicitis aguda, lo que plantea desafíos diagnósticos.
Objetivo del estudio:
- Reportar un caso de perforación del intestino delgado causada por la ingestión de material vegetal.
- Destacar las limitaciones diagnósticas de las imágenes en tales casos.
- Contribuir a la literatura sobre abdomen agudo debido a la ingestión de material vegetal en regiones específicas.
Principales métodos:
- Reporte de caso de un hombre tailandés de 40 años con dolor en el cuadrante inferior derecho.
- El estudio diagnóstico incluyó pruebas de laboratorio y tomografía computarizada (TC) con contraste.
- Se realizó laparotomía exploratoria debido a peritonismo persistente a pesar de imágenes equívocas.
Principales resultados:
- La TC mostró un apéndice ligeramente dilatado pero sin un cuerpo extraño claro ni signos de perforación.
- La laparotomía exploratoria reveló un fragmento de madera de 2.5 cm de *Gnetum gnemon* en el íleon terminal, causando perforación.
- Se extrajo el fragmento, se reparó el defecto ileal y se realizó una apendicectomía con un curso posoperatorio sin complicaciones.
Conclusiones:
- Este caso subraya las limitaciones de las imágenes convencionales en el diagnóstico de perforación del intestino delgado por cuerpos extraños ingeridos.
- La ingestión de material vegetal debe considerarse en el diagnóstico diferencial del abdomen agudo, particularmente en regiones donde dichos alimentos son comunes.
- Puede ser necesaria una intervención quirúrgica temprana cuando la sospecha clínica es alta a pesar de imágenes no diagnósticas.
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