A Date Palm Stone Ileal Perforation Discovered During Treatment of a Strangulated Umbilical Hernia

Fofana Naby,Soumaoro Labile Togba,Oulare Ibrahima,Kondano Saa Yawo,Fofana Houssein,Diallo Aissatou Taran,Toure Aboubacar,Mamy Gnan Francis

doi:10.11648/j.js.20210905.13

Abstract

Ingestion of foreign bodies is a frequent reason for consultation or admission to the emergency room. It is frequently accidental and involves children whose peak age varies between 9 months and three years. Reported cases of intestinal perforation by stone are rare. Herein we report one case of ileal perforation with a date palm stone discovered during the treatment of an emergency strangulated umbilical hernia in a 2-year-old patient. Clinically, there was a painful, irreducible, non-expansive umbilical swelling with coughing and vomiting. The other hernial orifices were free. Temperature was 36°C, respiratory rate 98 movements per minute, pulse rate 23 beats per minute. Biologically, hemoglobin was 11.4 G/dl, white blood cells were 9 giga/l. The diagnosis of strangulated umbilical hernia was retained. Intraoperatively, we found a small loop incarcerated in the umbilical ring and perforated in two places by a date palm stone. We proceeded with extraction of the stone, resection with both holes, followed by terminal ileo-ileal anastomosis. The postoperative course was simple and no complications were noted after a 2-year follow-up.

Highlights

Hernial strangulation is a serious and dreadful complication of hernia
Foreign body ingestion is a frequent reason for consultation or admission to the emergency room
Foreign body ingestion is accidental in 80% of children aged between 9 months and 3 years [2]

Summary

Introduction

Hernial strangulation is a serious and dreadful complication of hernia. It can occur at any age and unexpectedly. It is characterized by stricture of the hernial contents within the sac and produces an occlusive syndrome [1]. Foreign body ingestion is a frequent reason for consultation or admission to the emergency room. Foreign body ingestion is accidental in 80% of children aged between 9 months and 3 years [2]. The ingested foreign bodies reported in the literature are very diverse. Cases of ileal perforation caused by a date palm stone are not reported in the literature to our knowledge. We report a case of ileal perforation caused by a date palm stone discovered during surgical treatment of an emergency strangulated umbilical hernia

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