Unusual cause of colonic perforation secondary to an eel: a case report and literature review

Colonic perforation is a common presentation at the emergency department. However, foreign-body-related perforation is responsible for < 1% of these cases. Here we describe a case of colonic perforation secondary to self-introduction of an eel into the anus. A 54-year-old previously healthy man presented himself to the emergency department with a 12 hour history of abdominal pain. Physical examination revealed abdominal tenderness, re-bound tenderness, and involuntary guarding. A computed tomography (CT) scan of his abdomen and pelvis revealed a foreign body in the abdominal cavity. Upon further questioning, the patient admitted an eel was inserted into his anus by accident. The patient underwent a laparotomy, and the eel was subsequently removed. He was transferred to the standard ward from the emergency intensive care unit after 7 days without postoperative complications. Diagnosing a colonic foreign body can be challenging as patients often deny the insertion. A CT scan is recommended for patients suspected of having a colonic foreign body.