... http://www.jmedicalcasereports.com/content/1/1/159Page 2 of 4(page number not for citation purposes) A further two years later he was admitted to Accident andEmergency with generalised abdominal pain, distension,and vomiting. On arrival, ... arrival, he was found to be hypotensive,tachycardic and peripherally shut down. Abdominalexamination revealed distension and generalised abdom-inal tenderness with localised peritonitis over the ... fragments or fruitscontaining many seeds (such as the prickly pear) shouldbe accompanied by the awareness that large quantitiesmay cause faecal impaction [12].In our case, it is difficult to...