US surgeons have issued unusual — yet sage — advice to chew one’s unpeeled kumquats carefully before swallowing, after an elderly man who ate the fruit whole had a small bowel obstruction.

The team, which was “totally surprised” by the case, said the kumquats acted as bezoars and ultimately led to resection of a 70cm length of intestine.

“As such, we recommend that it should be peeled first before enjoying the fruit,” the doctors wrote in Cureus.

Their 86-year-old patient presented to an ED in Richmond, Virginia, with a one-day history of diffuse abdominal pain, nausea and feculent emesis.