Live Eel Punctures Fisherman’s Colon After Rectal Entry

The patient: A 55-year-old Bangladeshi man presented to the emergency department.

The symptoms: He reported severe abdominal pain that began approximately five hours prior to arrival.

What happened next: Physical examination revealed normal temperature and blood pressure, with mild tachycardia at 110 bpm.

The patient reported that the eel had accidentally entered through his rectum the previous day while he was wearing a lungi, a traditional long skirt. He explained that the eel slid through the opening at the bottom of the garment and into his anal canal.

He delayed seeking care, hoping the eel would exit spontaneously.

Abdominal examination revealed rigidity and tenderness. An X-ray showed a dark, eel-shaped shadow on the right side of the abdomen.

The diagnosis: The X-ray revealed a crescent-shaped gas shadow beneath the right diaphragm, suggesting peritonitis — inflammation of the peritoneal membrane. While peritonitis is typically infectious, it can also result from leakage of fluid from abdominal organs.

Without prompt treatment, peritonitis can progress to a life-threatening systemic infection.

The treatment: The patient received intravenous antibiotics, fluids, and anti-ulcer medications to protect mucosal layers and prevent deeper tissue injury.

Given the risk of septicemia, surgeons performed an emergency laparotomy to extract the eel.

The surgeons incised the sigmoid colon and removed the eel from the peritoneal cavity.

The eel, measuring nearly 2.2 feet (0.6 m) and still alive, likely survived by penetrating the colonic wall into the peritoneal cavity, which contains lubricating fluid rich in water, glucose, electrolytes, proteins, enzymes, white blood cells, and urea.

A sigmoid colostomy was performed to divert fecal matter and allow the damaged colon to heal. The patient was discharged four days later without symptoms, though no follow-up was reported.

What makes the case unique: Traumatic intestinal perforation by foreign bodies is uncommon, and cases involving live animals are exceedingly rare. Objects may enter the body through accidental ingestion or deliberate rectal insertion, including items such as vibrators, chicken bones, light bulbs, metal rods, glass bottles, and kitchen whisks.

Colon penetration by a live fish is an unusual, scarcely documented event. The authors cited a prior case in Hong Kong involving a 50-year-old man who knowingly inserted a 1.6-foot eel into his rectum to relieve constipation.

Source link