Medicine: The curious case of the metallic Cuban cigar sheath

Medical doctors sometimes have to play detective, as happened in this, the curious case of the metallic Cuban cigar sheath:

shamir-cawichColonic Foreign Body Retrieval Using a Modified TAMIS Technique with Standard Instruments and Trocars,” Shamir O. Cawich [pictured here], Fawwaz Mohammed, Richard Spence, Matthew Albert, and Vijay Naraynsingh, Case Reports in Emergency Medicine, Volume 2015 (2015), Article ID 815616. The authors, at University of the West Indies, Trinidad and Tobago, and The Center for Colon and Rectal Surgery, Altamonte Springs, Florida, USA, report:

“[In the case we describe here] a plain radiograph of the pelvis… revealed an unexpected finding… With this unexpected finding, the history was revisited. Only then did the patient confess to his habit of inserting an object into the rectum for self-eroticism. The object used on this occasion was described as a metallic Cuban cigar sheath that had a tapered tip….

“it has been established that many patients with CFB are deceptive historians [2, 3]. As many as 20% of patients will not divulge their history of CFB insertion at presentation [4] because the practice is still considered taboo. To overcome this barrier, clinicians should approach these patients in a candid manner in order to earn their trust during history taking. An accurate history is important to ascertain the diagnosis because any delay increases the risk of complications.”

Here’s further detail from the study: