I read in the newspapers a few days ago about a man caught smuggling gold into the country by placing it in his rectum. The Police were at a quandary on how to retrieve it. Their only option was to given him a megadose of laxatives and make sure he defecates in their presence and in a bedpan! This method of smuggling is far from ingenious I have read the South American drug cartels used this method for smuggling cocaine into the USA. The processed cocaine was packed in cylindrical plastic bags and after adequate lubrication pushed up retrograde into the rectum of the couriers. These couriers had the uncomplimentary sobriquet of ‘mule’. Though it did accurately described their job of physically transporting goods from one point to the other.
In the 1970s book ‘Papillon’, by Henri Charriere, an autobiography. He describes how he was wrongly accused of murder in France and sentenced to life imprisonment in the French Penal Colony of French Guiana. He further goes on to describe that the only way they could keep their money safe from the other prisoners and the guards was to roll it up tightly into a metal cylinder, called charger. This cylinder was inserted into the rectum and the author confesses he got so used to this method that even after he escaped he continued using a charger to keep his money safe. He never elaborated how he removed the charger!
Though now this method would not be of much use as a digital examination of the rectum is included in the protocol of frisking of prisoners.
A glance into Bailey & Love’s ‘Short Practice of Surgery’, has a section on the foreign bodies in the rectum. I quote “The variety of foreign bodies which have found their way into the rectum is hardly less remarkable than the ingenuity displayed in their removal. A turnip has been delivered per anum by the use of an obstetric forceps. A stick firmly impacted has been withdrawn by inserting a gimlet into its lower end. A tumbler, mouth looking downwards, has been extracted by filling the interior with wet plaster of Paris bandage, leaving the end of the bandage protruding, and allowing the plaster to set. A pepper pot which when removed had the inscription, ‘a gift from Marsgate’. A screwdriver and a live shell which had to be handled carefully.“
In my surgical practice I have encountered my fair share of ‘foreign objects’ in the rectum. More ingenious than the objects themselves is the explanation of how they came to reside there albeit temporarily. When I was doing my MS, I was called to the casualty to attend on a patient. The patient was an elderly man in his 60s. He told me that he suffers from piles and was using an Ayurvedic medicine which had to be applied locally. The Ayurvedic medicine was dispensed in an old Benedryl bottle (cough syrup). He apparently was sitting on his haunches on the floor, applying the medicine with his finger to the area. The bottle was also placed next to him and then he shifted a bit and accidentally sat on the bottle! And up went the bottle! This explanation caused sniggers amongst the junior staff and incredulous look on the face of the seniors. For retrieving this bottle we used the obstetrics forceps which is used to deliver the head of babies in prolonged labour.
Then there was the case of the middle aged man who was brought with severe abdominal pain. He admitted to being gay, though he was the AC/DC type. He had a wife and two children. He was accustomed to inserting a stick into his anus for the purportedly pleasure it gave him. That day he pushed it up a little too much and it perforated the intestine. This caused a serious condition called ‘fecal peritonitis’, stool contaminating the abdomen. The patient had to be operated and the perforation closed. A temporarily colostomy or an ‘artificial anus’ also had to be constructed.
I was working in a Mission Hospital in rural Madhya Pradesh. A young male patient had been admitted a day earlier with abdominal pain. Since he did not give any other significant history the medicine people admitted him. The next day he passed large quantity of blood in his stools. I was given a call and I ordered an X-ray abdomen standing. To my surprise there was massive air in the peritoneal cavity, which indicates perforation of an intestine. I took him for surgery and was amazed to find not just a simple perforation but complete transection of the intestine! Not only a foreign object was pushed up but it was done with a considerable amount of force. When the patient recovered from anaesthesia I asked him how did it happen? He told me a different story every time. One of the stories was that he was sitting on a tree and fell off. An upright twig went up the wrong end. This was possible but not plausible, the main hole in this story was how did the twig reach the opening so accurately without causing any collateral damages?
The patient never told me the truth!
The most recent incident is just 4 days ago, an 18 year old male was brought to the hospital with a history of having fallen on a construction rod from a height. Again they appeared to be no collateral damages, the rod had accurately entered the anal opening. He also had perforation of the intestine. I have not even bothered to ask the patient for any further details and taken his story at face value.