Watch out for that prickly pear! How small seed caused unique case of food-pipe perforation

Sinking your teeth into the juicy flesh of a prickly pear during these hot summer days seems like the most natural and indeed harmless of actions, but a recent case study published in the Malta Medical Journal has uncovered a potential danger to the fruit that you may never have imagined…

Prickly pears are sought after both for their taste, and for their nutritional value – they are said to have the potential to lower harmful cholesterol and treat diabetes among other benefits. Their side effects, on the other hand, seem to be very few on the whole, ranging from diarrhoea to bloating, according to WebMD, but even these are brought on by excessive ingestion rather than by the fruit itself.

However, doctors at Mater Dei hospital recently encountered what they called a “unique case” of oesophageal perforation caused by the fruit. In their case study, published in the Malta Medical Journal, Dr Hermann K. Borg Xuereb and medical student Stefan Malaguti note that a 20-year-old male was admitted into the Accident and Emergency Department after ingesting just two peeled prickly pears. The patient in question reported an unpleasant feeling in his throat, causing him to have difficulty breathing, swallowing, and a general pain in his mouth and oesophagus (food-pipe).

Following a number of tests, it was determined that the patient had suffered a small perforation in his food-pipe, as a result of eating the fruit. 

Although the case in question was easily treated through a course of medication and monitoring by hospital for some seven days, oesophageal perforation can sometimes have tragic consequences unless it is diagnosed in under 24 hours. Indeed some medical websites claim that if it goes untreated, it can be fatal, with surgery being required in the majority of cases. Borg Xuereb and Malaguti add however that such perforations are not unheard of, with some three in every 100,000 people suffering from them in the United States. 

The remarkable thing in this case, however, is the cause of the perforation. Compared to the usual causes, namely injury occurring during surgery, tumours or traumas to the chest or neck, eating a prickly pear seems to pale in comparison. Perhaps it’s the slightly abrasive, small seeds of the fruit, which although slightly annoying prove too small and plentiful to sift out, but however rare, a quick Google search reveals that health information sharing website eHealth.me has a support group page dedicated to the phenomenon (Prickly Pear Cactus and Esophageal Perforation). 

Although not meaning to scare you off the fruit unnecessarily, perhaps such a case, however rare, ought to alert us to the importance of speaking up the moment something is amiss…