A 28-year-old male presented to the emergency department with abdominal pain and constipation for hours.
The patient has no history of interest, but realizes that he has been forced to drink "hachís balls" 24 h before going to the emergency department.
On admission to the hospital, the patient presents diffuse pain, with no fever or peritonitis characteristics of pain on examination.
Analytically, there are no alterations, and in the abdominal X-ray there are levels of thinner without cecum dilatation so conservative management is decided.
After 24 h of evolution the patient continues with pain and signs of intestinal obstruction associated with slight peritoneal irritation in the left hemiabdomen so surgery is decided.
During surgery there is perforation in the rectosigmoid junction caused by one of the "ingested keloids" with fecal peritonitis.
Hartmanns anomaly was performed with extraction of 26 foreign bodies identified as hachís balls.
After 72 h, the patient developed a new condition of intestinal obstruction, so he was reoperated urgently and washed the colon with removal of 16 foreign bodies.
The patient's postoperative course is characterized by infection of the surgical wound and an episode of paralytic ileus, but is discharged after 30 days of hospitalization.
