Case of the deadly santol seeds

Posted: 7:37 PM (Manila Time) | September 07, 2001
Inquirer News Service

Potentially fatal problem IF you’re fond of santol and you swallow the seeds when you eat it, you are exposing yourself to a potentially life-threatening risk.

Mameng A., a 55-year-old housewife, has always been fond of santol for as long as she could remember. She would eagerly look forward to the santol season each year and made sure she always had ample stock of the fruit in her refrigerator. Her meal would never be complete without santol, serving both as her appetizer and dessert.

She never swallowed the seeds though until recently when her best friend convinced her that it was fun swallowing them. She tried it and she agreed with her best friend, until a few months ago when she developed severe abdominal pains accompanied by progressive abdominal distention. It all started when she had eaten three santol fruits, swallowing all the seeds. For three days, Mameng took various antispasmodics and painkillers, which only afforded temporary relief of the pain.

Finally, the pain became unbearable making her double up to ease it somehow. She was rushed by her then frantic husband to the Ospital ng Maynila Medical Center (OMMC). Dr. Janix de Guzman, surgical resident, diagnosed her to have intestinal obstruction and his consultants agreed with his assessment and recommendation to do an emergency operation (exploratory laparotomy) on Mameng.

The doctors found an obstruction in the large intestines with a hole or perforation just before the obstruction. Several santol seeds were found lodged in that area, with the tip of one seed protruding out of the wall of the intestines. All the doctors concurred that the seeds caused Mameng’s bowel obstruction and perforation.

Dr. Reynaldo Joson, head of surgery at the OMMC, warns in an advisory issued by his department that santol seeds inside the intestines can cause serious, even potentially fatal complications. "Most of the time, the seeds will be passed out through the anus during bowel movement," Dr. Joson explains. "However, in some cases, the seeds may cause intestinal obstruction by sticking together to form a hard bolus of seeds or by completely plugging the intestinal lumen that has been previously and partially constricted by a disease like a tumor or tuberculosis."

Dr. Joson continues to explain that the seeds may also cause perforation of the intestines. After the fibers enveloping the seed have been digested, the remaining shell, which is indigestible, is usually sharp at its two ends. These sharp ends can perforate a normal intestinal wall, especially if it has been weakened by a disease or a generative condition such as repeated inflammation or diverticulosis of the intestines.