A 40-year-old man arrived at a Qatar emergency department with four days of severe anal pain, mild abdominal pain, and constipation. An abdominal X-ray ruled out obstruction. A rectal exam found no fissure, no hemorrhoid. His bloodwork was normal apart from a mildly raised white cell count. He passed stool after an enema and went home.
Three days later, he came back with fever, vomiting, and pain that had gotten worse. This time, he told the staff something he had left out. Three days earlier, during a bowel movement, he had reached in and pulled a piece of meat bone 5 to 6 centimeters long out of his own anal canal.
