Don’t forget the syrup!

Every ER doctor and nurse is going to have a collection of stories about patients who have inserted objects into their rear-ends, apparently for purposes of pleasure, and then were unable to extricate these objects. These “foreign body” stories often provide a brief period of amusement during what is usually a hectic and/or grueling shift in the ER, and they also give us doctors interesting anecdotes to share with our families the next day. It’s not always funny though. Sometimes the “lost” object may be so far gone into the “nether regions” that it evades our attempts at retrieval and the patient has to be transferred to the operating room. General anesthesia and further attempts at removal sometimes culminate in surgery to open the abdomen and colon to take out the offending object – kind of like a bizarre version of a c-section. Helluva way to end a night of self-pleasure; abdominal surgery is a pretty high price to pay for a self-inflicted condition that could have easily been avoided with a little common sense.
Recently I had a gentleman in his 40’s arrive in the ER complaining of abdominal pain. While interviewing him to investigate his condition he admitted to inserting an object in his rectum earlier that evening and he was now quite concerned after being unable to expel it despite numerous attempts. I could feel a firm mass in his lower abdomen so I obtained an abdominal X-ray to get a better idea of what was going on and to make sure he hadn’t perforated his colon. The X-ray revealed an object in the sigmoid and descending colon that was too large and irregularly shaped to be a garden variety dildo that we usually see in the ER. After administering medications for pain and anxiety so that the patient would be relaxed I was able to feel the object during rectal exam. Despite several minutes of coaching the patient to push while I attempted to manipulate the object we were unsuccessful at delivering the object. Apparently it was hung up on the patient’s coccyx and would not go any further. Frustrated, but not giving up, I had the patient reposition himself on his hands and knees and resume pushing while I directed the exodus of the object which was now hanging free of the coccyx. Since it was no longer hung-up the object was rapidly expelled from the patient’s rectum (almost as if it wanted out), and I successfully delivered a quart-sized Aunt Jemima bottle still full of syrup. Ugh! All I could think about were those TV commercials where an animated matronly Aunt Jemima giggles sweetly and encourages you to buy her syrup to sweeten your pancakes and waffles. I don’t think she ever promoted her product by asking people to buy her, take her home, and stick her up their butt. Yuk! Poor Aunt Jemima, I’d hate to hear what she’d have to say as she approached the asshole of death (“aw hell-to-the-nawh! You are NOT putting me in there!! you better turn this around RIGHT now you crazy sonuvab#tch!). And what was this innocent breakfast condiment thinking while she was trapped for several hours with her face shoved up against his spleen suffocating in his pungent colon (“get me the F*#% out of here!”)-- I can almost hear her muffled screams echoing off the walls of his large intestine. I’m not really sure why anyone sticks objects up their rear-ends, but, come on, what type of sadistic pleasure do they get from reaming themselves with poor ole Aunt Jemima? The best part of this story is that, due to hospital protocols to reduce liability, all tissue or objects that are removed from the human body have to be sent to pathology for identification. Bored pathologists have to file reports of their findings such as “object is consistent with syrup bottle”. At least the object is confiscated and the patient can’t reuse it and end up in the ER again; that is until they lose something else up their butt. Of course the patient had to eat his pancakes plain the next morning, but at least he avoided the OR and exploratory abdominal surgery.