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

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.