A 55-year-old fisherman in Bangladesh went to the hospital with severe abdominal pain and signs of peritonitis. His case was published in the International Journal of Surgery Case Reports. The cause was an eel that had slipped under his clothing and entered through the rectum, reaching the intestine. The patient admitted he had waited 24 hours before seeking care, hoping the animal would leave on its own. The physicians who reported the case noted that ingestion or insertion of foreign bodies is not uncommon in certain occupations or recreational activities, but penetration of the intestine by a live animal — in this instance a fish — is rare and poorly documented.

An abdominal X-ray showed gas and the presence of the eel. Only one other similar case has been recorded, in Hong Kong in 2004, but in that instance the man had deliberately inserted the animal into his anus in an attempt to relieve constipation. The Bangladeshi patient faced risks of peritonitis and pneumoperitoneum from air in the abdomen, with possible intestinal wall rupture and severe infection. Surgical intervention was required to remove a 65-centimeter eel that was still alive. The doctors commented that how the eel passed through the anal canal and perforated the colon raises interesting questions about both the fish’s behavior and human gastrointestinal anatomy.

The fisherman recovered relatively quickly and was discharged after four days in hospital without further pain or complications. The medical team gave two recommendations: avoid similar incidents in the future, and seek immediate medical attention if a similar event occurs again instead of waiting 24 hours.