This story took place during the spring of 1976 in the Charity SICU. It involved an unfortunate young man who presented with a large bowel obstruction from what on X-ray appeared to be a softball. On intense questioning the patient denied knowledge of how it got there. The ileocecal valve was competent, so, in order to avoid a diverting colostomy, our only hope was to remove the obstructing object from below. It was a challenge that was left to my third year resident and me, a lowly first year resident. (As an interesting aside, the two of us ultimately ended up practicing together for many years in West Virginia and recounted this event on multiple occasions.)
After an extended period of attempting to remove the object digitally with no success, it was obvious that something outside the box would be necessary, if we were going to avoid surgery. I can’t remember who first came up with the idea, but we quickly decided that we needed to call down to OB to obtain a pair of obstetric forceps. We obtained them quickly and, after trying to recall what little we had learned about these instruments from medical school, in about 30 minutes we were able to deliver a healthy, but slightly bloody regulation-sized softball. Apgar was undetermined. We congratulated ourselves, but, sadly, the story did not have a happy ending, as the patient, sometime during our struggle or shortly thereafter, perforated his cecum, developed overwhelming sepsis, and died.
Needless to say, our series of one rectal softball delivery was never reported.
Dan Foster
Tulane Surgery ’79
