Rosemary-induced Peritonitis: A Case of Small Bowel Perforation

Abstract

Introduction: Perforation of the gastrointestinal (GI) tract by ingested foreign bodies is extremely rare, especially when talking about commonly used aromatic herbs, the perforation can nonetheless occur in patients with a hernia sac or Meckel’s diverticulum.  Case Report: We report a case of a 70 YA female admitted with abdominal pain and whose investigation (Abdominal CT) showing pneumoperitoneum led to an exploratory laparotomy that revealed a punctiform perforation of the small intestine caused by an ingested sprig of rosemary treated with simple sutures of the perforation. The evolution was normal with no complication. To our knowledge, no such case has been reported in the literature. Discussion: Meckel’s diverticulum is the most common congenital gastrointestinal malformation. The perforation of a Meckel’s diverticulum by a foreign body is a very rare complication, with few cases reported in the literature. Rosemary (Rosmarinus officinalis L) is a medicinal plant native to the Mediterranean region and cultivated around the world. It is commonly used here in Morocco as herbal infusion with tea or as aromatic herb in several local dishes. There’s no case of bowel perforation caused by this herb found in the literature which makes this case report very uncommon. Conclusion: The majority of ingested foreign bodies pass through the GI tract without complications. However, in some cases it can lead to GI tract perforation and develop acute peritonitis. The patient was unlucky to have a physiological condition such as Meckel’s diverticulum which weakened the bowel wall.