A 55-year-old fisherman in Bangladesh waited a full day before seeking help after a live eel entered his body through his rectum, and by the time he reached the emergency room, the animal had torn through his colon wall.
The case, published in the International Journal of Surgery Case Reports, details one of the more unusual medical emergencies in recent literature: a nearly 2.2-foot-long eel that wriggled into a man's anal canal while he was fishing, perforated his intestine, and ended up alive inside his peritoneal cavity, the space surrounding the abdominal organs. Surgeons had to operate immediately to save his life.
The fisherman told doctors the eel had entered through the opening at the bottom of his lungi, a traditional garment similar to a sarong, while he was catching fish. He did not go to a hospital right away, hoping the eel would find its way back out on its own. It did not. Instead, the animal bored through the colon wall and lodged itself deeper inside his body.
By the time the man arrived at the emergency department roughly a day after the eel entered his body, he had already endured five hours of intense abdominal pain. Doctors found his abdomen swollen and tender.
An X-ray told the rest of the story. The Sun reported that imaging revealed an eel-shaped shadow inside the patient's body, along with a crescent-shaped shadow, a hallmark sign of peritonitis, meaning air had escaped into the abdominal cavity through the punctured colon.
Peritonitis left untreated can quickly turn into septicaemia, a life-threatening blood infection. Doctors decided they could not wait.
Surgeons opened the man's abdomen and extracted the eel from the peritoneal cavity. The animal was still alive when they pulled it out.
The fisherman recovered quickly. Four days after surgery, he was symptom-free and discharged from the hospital. The published case report did not mention whether he needed any follow-up appointments.
The Bangladeshi medics who authored the report acknowledged that foreign-body cases are not rare in emergency medicine, but stressed that this one stood apart. They described it as a "unique case of traumatic intestinal perforation resulting from the accidental entry of an eel fish into the rectum."
"The penetration of the intestinal wall by a live animal, such as a fish, is an unusual and scarcely documented event."
The authors also urged fellow physicians to stay alert to occupational hazards that most doctors would never think to ask about.
"This case highlights the necessity for vigilance in recognising unusual causes of abdominal pain, especially in individuals with relevant occupational or recreational exposures."
Strange as the Bangladeshi fisherman's ordeal sounds, foreign objects lodged in patients' bodies are a regular fixture in emergency rooms worldwide. In the United Kingdom, data analysis tied to the National Health Service found that doctors pull roughly 400 foreign objects from patients' anuses every year. Reports of objects stuck in intimate areas appear in medical literature dating back to the 16th century.
None of that history makes a live eel perforating a man's colon any less extraordinary. The case report's authors made clear that a living animal actively tearing through the intestinal wall puts it in a category almost entirely its own.
The fisherman survived, and the system worked, but only because he finally walked through the hospital doors before sepsis set in. A day of hoping the problem would solve itself nearly cost him everything.
