A "madd"-ening confounding: fruit seeds mimicking enteral drug concealment by computed tomography.

Journal: Clinical toxicology (Philadelphia, Pa.)

Volume: 61

Issue: 7

Year of Publication: 2023

Affiliated Institutions:  Division of Medical Toxicology, Ronald O. Perelman Department of Emergency Medicine, NYU Grossman School of Medicine, New York, NY, USA. Division of Pediatric Emergency Medicine, Ronald O. Perelman Department of Emergency Medicine, NYU Grossman School of Medicine, New York, NY, USA.

Abstract summary 

To highlight the similarity between madd fruit seeds and enteral drug concealment ("body packing") on computed tomography when evaluated by Hounsfield Units.A 13-year-old girl from Senegal presented to the Emergency Department with severe abdominal pain. Examination showed right lower quadrant tenderness with rebound. Computed tomography scan of the abdomen and pelvis revealed smooth, well circumscribed, multiple intraluminal foreign bodies measuring up to 2 cm in size with Hounsfield Units measuring up to 200. The emergency department radiologist reported that these were suspicious for "body packer packets" of either opioids or cocaine, based on their appearance and Hounsfield Unit characteristics. Dietary history later revealed consuption of madd fruit () seeds, which can cause bezoar formation and intestinal obstruction.Madd fruit seeds may appear similar to drug packets on computed tomography with similar Hounsfield Unit characteristics. History and clinical context are paramount to avoid misdiagnosis.

Authors & Co-authors:  Wiener Brian G BG Burton Rebecca L RL Smith Silas W SW Su Mark K MK Biary Rana R Tay Ee Tein ET

Study Outcome 

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Statistics
Citations : 
Authors :  6
Identifiers
Doi : 10.1080/15563650.2023.2227760
SSN : 1556-9519
Study Population
Girl,Female
Mesh Terms
Female
Other Terms
Madd Fruit;Saba Senegalensis;body packer packet mimics;hounsfield units
Study Design
Study Approach
Country of Study
Senegal
Publication Country
England