Today, September 26, 2012, during our Division I conference in the Philippine General Hospital, there was a report of a santol-seed-induced intestinal perforation.
The patient was a 72-year-old Filipino male who ingested santol seeds previously. When he consulted the Philippine General Hospital (PGH), he was already having abdominal pain for 5 days. He was operated twice. On the first operation, the surgeon was not able to determine the cause of the intestinal perforation. Washing of the abdominal cavity and release of adhesions were just done. One day after the first operation, the patient had to be operated again because there was persistence of the abdominal problem. This time, the surgeon saw a sigmoid colon perforation caused by a swallowed santol seed. A sigmoid colostomy was done. The patient right now is in critical condition.
I asked the surgical residents how many cases of santol-seed-induced intestinal perforation have already been operated in PGH this year. I was told this was the first. I had reported two patients in Manila Doctors Hospital and two in Ospital ng Maynila Medical Center. So, this is the fifth patient that I was made aware of and which I am including in my 2012 registry.
Lessons and reminders:
1. For the surgical residents and consultants, always include santol-seed-induced intestinal perforation as a differential diagnosis during the santol season in the Philippines for patients presenting with acute surgical abdomen.
2. For the public, please do not, I repeat, do not swallow santol seeds. They will perforate your intestines after which you will be operated on. You can die just because of swallowing santol seeds.