Scary blow-up and unnecessary kidney removal after oral sex

This medical report presents a cautionary story — the possibly-unnecessary removal of a body part:

shamir-cawichNon-surgical pneumoperitoneum after oro-genital intercourse ,” Shamir O. Cawich [pictured here], Peter B. Johnson, Eric Williams, Vijay Naraynsngh, International Journal of Surgery Case Reports, epub September 25, 2013. The authors, at the University of the West Indies, Mona Campus, Jamaica, report:

“A 21-year-old woman with a body mass index of 22.3 presented to hospital complaining of sudden onset right-sided abdominal pain…. She was taken to the operating room for abdominal exploration through a midline laparotomy incision. An enlarged right polycystic kidney was encountered… a right nephroureterectomy was performed…. Upon further detailed questioning she admitted to engaging in sexual activity approximately four hours prior to CT scanning. Specifically, there was cunnilingus lasting approximately 15 min and that was followed by regular vaginal intercourse. She denied deliberate vaginal insufflation… This reinforces the need to take a thorough history because most patients will not volunteer sexual histories since they cannot readily make a link between sexual practices and their symptoms or radiographic findings. This may prevent the exposure of these patients to expensive investigations and non-therapeutic laparotomies.”

These two images from the study show (Figure 1) the misleadingly inflated body part being removed from the body, and  (Figure 6) the patient’s “flat abdomen” after removal of same.