An 86-year-old Japanese man presented with acute abdominal pain and nausea that had persisted for the previous 12 h. He had no surgical history. He ate Japanese food with pickled plum the night before, accidentally swallowing the seed. Severe abdominal tenderness around his navel with hypoactive bowel sounds was observed. Abdominal computed tomography (CT) showed a curious heterogeneous, high-density mass in the small intestine with proximal intestinal dilation (Fig. 1). Comparing the CT image with cross-sectional view of the pickled plum’s seed (Fig. 2), intestinal obstruction (IO) due to picked plum seed was diagnosed. His symptoms improved after surgical removal of a pickled plum seed and partial small-bowel resection. Surgical findings revealed no underlying disease of the small intestine.

Fig. 1
figure 1

Abdominal computed tomography showed a curious heterogeneous, high-density mass in the small intestine with proximal intestinal dilation (arrow)

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Fig. 2
figure 2

Cross-sectional view of the pickled plum’s seed. There is a white fruit wrapped in a thin skin, inside a seed of pickled plum

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Food-induced IO can be caused by persimmons, hawthorns, sweet potatoes, rice cakes, and plant seeds.1,2,3 IO caused by plant seeds is rare because seeds are often oval and small.3 In most cases of IO, there is underlying gastrointestinal disease such as cancer or anastomotic stenosis.3 Food-induced IO can be treated conservatively when caused by easily digestible foods, such as rice cakes,2 but surgical treatment is necessary when IO is caused by larger foods that are difficult to digest, such as pickled plum seeds.4,5