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Intestinal Perforation Secondary to Pits of Jujube Ingestion: A Single-Center Experience with 18 Cases

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Abstract

Background

Ingestion of jujube pits is a common clinical problem, which can be difficult to diagnose and life-threatening if accompanied with intestinal perforation and peritonitis. In this study, 18 cases of intestinal perforation caused by ingestion of jujube pits were reviewed and summarized to discuss the clinical characteristics, diagnosis and treatments.

Methods

From 2012 to 2018, a total of 18 patients diagnosed as intestinal perforation due to ingested pits of jujube in our center were retrospectively reviewed and the manifestations, laboratory tests, imaging examinations and treatment strategies were summarized.

Results

The patients comprised of 11 males and 7 females with an average age of 63.5 years. The main clinical manifestation was abdominal pain. Twelve patients (67%) presented to the emergency department with signs of localized peritonitis. CT imaging revealed positive findings in 17 (94%) patients. Conservative treatments were attempted in 3 patients, and the other 15 patients received emergency surgical exploration, where 7 patients had more than one perforation identified during surgery. Five patients were admitted in the surgical intensive care unit after surgery. The average length of stay of all 18 patients was 9.8 days (range 5–24 days).

Conclusion

Ingestion of jujube pits is a common clinical problem and potentially leads to intestinal perforation and peritonitis. CT imaging is the first imaging modality of choice. Patients with milder symptoms might be managed with cautious conservative treatment, and patients with more than one perforation can be identified during surgery.

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Acknowledgements

Authors would like to thank Professor Yimu Jia who provided photographs taken during surgery.

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Authors and Affiliations

  1. Department of General Surgery, Peking University Third Hospital, Beijing, 100191, China

    Fei Li, Xin Zhou, Bingyan Wang, Lei Guo, Yanpeng Ma, Dechen Wang, Liang Wang, Li Zhang, Hangyan Wang, Lingfu Zhang, Maolin Tian, Ming Tao, Dianrong Xiu & Wei Fu

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  1. Fei Li
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  2. Xin Zhou
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  3. Bingyan Wang
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  4. Lei Guo
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  5. Yanpeng Ma
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  7. Liang Wang
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  8. Li Zhang
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  9. Hangyan Wang
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  13. Dianrong Xiu
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Correspondence to Wei Fu.

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Informed consent was obtained from all individual participants included in the study.

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Li, F., Zhou, X., Wang, B. et al. Intestinal Perforation Secondary to Pits of Jujube Ingestion: A Single-Center Experience with 18 Cases. World J Surg 43, 1198–1206 (2019). https://doi.org/10.1007/s00268-018-04902-y

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