The symptoms: The man went to the emergency room with severe abdominal pain that he said began five hours prior to his visit.
The man explained that one day earlier, an eel had "entered through his rectum accidentally," his doctors wrote in a report of the case. At the time of the encounter, the man was wearing a lungi — a type of long skirt often worn by Bangladeshi men — and he explained that the eel entered his lungi through the opening at the bottom and then wriggled into his anal canal.
When the doctors kneaded the patient's abdomen, it was rigid and tender. They ordered an X-ray, which revealed a dark, eel-shaped shadow on the right side of the abdomen.
If the condition is not treated quickly, it can lead to a life-threatening infection that can spread rapidly through the body.
Due to the peritonitis, the doctors determined that the patient was at risk of septicemia, or "blood poisoning," in which pathogens invade the bloodstream. They decided to operate on the patient immediately and remove the eel via a laparotomy, a surgical technique that creates an opening in the abdominal wall and provides access to the pelvic organs.
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The surgeons then performed a sigmoid colostomy, creating an opening in the abdomen as an exit point for contents of the man's large intestine. In this way, they bypassed the damaged section of sigmoid colon to prevent leakage of fecal matter that could lead to further infection. Four days later, the man was symptom-free and was discharged from the hospital. The report did not document any follow-up visits.
Penetration of the colon by a live fish is an "unusual and scarcely documented event," the man's doctors added in the report. They noted one reference to such a case that appeared previously in scientific literature and involved a 50-year-old male patient in Hong Kong. In that case, the man knowingly inserted the eel — which measured more than 1.6 feet (0.5 m) long — into his rectum, allegedly in an attempt to relieve his constipation.
Can you guess the diagnosis in these strange medical cases? Find out with our diagnostic dilemma quiz!
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