Intestinal obstruction due to food.

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Intestinal obstruction due to impacted foodstuffs is a rare but interesting and well-recognized surgical emergency. The incidence of this type of obstruction may be assessed from the analysis by Storck, Rothschild, and Ochsner (1940) of a series of 875 cases of acute intestinal obstruction, excluding those due to herniae, neoplasms, or peritonitis, and treated at the Charity Hospital, New Orleans. Of these, 51 were due to foreign bodies, and of this number five were caused by the impaction of food boluses. Handfield-Jones and Porritt (1948) give the incidence of intraluminal foreign body obstruction as 0.3% of all cases of acute intestinal obstruction. Latchmore (1940) had the exceptional experi ence of operating in one year on no fewer than four cases of obstruction due to food. There have been only four such cases at the Radcliffe Infirmary in the last 20 years. One of these was due to orange pith, and has been reported elsewhere by Fleming and Ward-McQuaid (1950). Elliot (1932) listed 40 cases of food impaction, and Fantus and Kopstein (1940) brought this number up to 75. Since their paper, single instances of small series have been reported. Four further cases are now recorded?two due to orange pith, one to almonds, and one to watercress? so that, including the other case due to orange pith men tioned above, 178 cases have now been traced. Delrio, Paz, and Carpanelli (1944) discussed 31 cases, including 7 of their own ; but 13 of these have not been included, as the case histories are not reviewed in full and the relevant original South American publications are not available. It is clear that great numbers of cases occur and are not reported, and perhaps the bizarre examples are more likely to be recorded than those that are less unusual.