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Unusual association of diseases/symptoms
Case report
Peach pit impaction presenting as gallstone ileus
  1. Abdus Samad Syed1,
  2. Alexander Bonte1,
  3. Laith Adnan Allaham1 and
  4. Elliot R Goodman2,3
  1. 1Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
  2. 2Department of Surgery, Mount Sinai Health System, New York, New York, USA
  3. 3Department of Surgery, Beth Israel Medical Center, New York, New York, USA
  1. Correspondence to Dr Elliot R Goodman; egoodman{at}chpnet.org

Abstract

Small bowel obstruction (SBO) secondary to fruit pit impaction is rare. The presence of an ovoid, stony body in the bowel lumen on radiologic imaging in a patient presenting with signs and symptoms of SBO is likely to raise concern for gallstone ileus. We report the case of a 56-year-old man who presented with a 1-day history of intermittent left-sided abdominal pain and nausea associated with a single episode of vomiting. CT scan of the abdomen and pelvis revealed a 3.3 cm impacted stony mass in the terminal ileum resulting in high-grade partial SBO. The mass had a hypodense centre encased within a hyperdense, ridged outer layer. The diagnostic impression was gallstone ileus. The object was removed via enterotomy and was found to be a peach pit.

  • gastrointestinal surgery
  • radiology

http://dx.doi.org/10.1136/bcr-2020-235363

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    Footnotes

    • Contributors ASS, AB and LAA: article writing and editing. ERG: provided care for patient and was involved in editing, proofreading and image contribution.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent for publication Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.