Subcutaneous date palm thorn

Case contributed by Dr Yair Glick

Presentation

Felt a painful prick to his abdomen while pruning date palm trees.

Patient Data

Age: 55 years
Ultrasound

Thin 2.7 cm-long linear foreign body obliquely oriented in the epigastric subcutaneous fat at the midline, at a depth of 3 mm from the skin surface, right beneath a small puncture wound, casting a delicate acoustic shadow.
No evidence of a subcutaneous edema or a fluid collection.

Of note, no calipers are seen because accurate measurements were made on the images sent to the PACS, right after the examination.

Photo

The ER surgeon extracted a date palm thorn from the patient's abdominal wall.

Case Discussion

Penetrating injury from a date palm thorn can result in quite a substantial injury, depending on the location of the penetration. It can also become infected with Pantoea agglomerans, a Gram-negative aerobic bacillus ubiquitous to plants, belonging to the family Erwiniaceae.

NB like most other organic material, thorns are virtually invisible on X-ray studies.

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