A Good Poop

Jail must really suck in Bulgaria

Losanoff JE, Kjossev KT. Gastrointestinal ‘crosses’. A new shade from an old palette. Arch Surg. 1996 Feb;131(2):166-9.

Okay, so within a single week in January of 1993, five male prisoners from the same Bulgarian prison were hospitalized with perforations of their gastrointestinal tracts. The perforations were the result of the prisoners’ intentional ingestion of ‘crosses’ made out of paper clips and rubber bands. Two halves of a paper clip were tied crosswise with a rubber band, pulled together to collapse the cross, wrapped in a piece of paper, and ingested. The paper came loose along the journey through the GI tract, permitting the paper clip sections to spring back into a cross and tear holes in the stomach and/or duodenum. The prisoners apparently did this in order to buy some ‘leisure’ time in the hospital.

Losanoff JE, Kjossev KT, Losanoff HE. Oesophageal “cross”–a sinister foreign body. J Accid Emerg Med. 1997 Jan;14(1):54-5.

Another report, published less than a year later, of a Bulgarian prisoner who intentionally ingested a ‘cross’ made out of sewing needles. An improvement on the paper clip method, if you will.

Vassilev BN, Kazandziev PK, Losanoff JE, Kjossev KT, Yordanov DE. Esophageal ‘stars’: a sinister foreign body ingestion. South Med J. 1997 Feb;90(2):211-4.

Less than a month later, yet another paper describing six consecutive Bulgarian prisoners, all from the same jail, who ingested ‘stars’ they had constructed out of hypodermic needles. Mmm, perforations and the risk of Hepatitis C or HIV.


  1. #1 phisrow
    January 19, 2008

    That is really quite gruesome. I makes one wonder both about prison conditions, and about the standards for hospitalization. Intentional perforation of the stomach and/or intestines seems like a really, really drastic measure. I would have thought that they could have used some less horrific injury to the same end.

  2. #2 samuraidoctor
    February 3, 2008

    This is interesting, but old news. When I was a resident at University of Maryland Hospital during the early 80’s, the state prison had a prison floor in the hospital. There was one inmate who was renowned for swallowing all kinds of things to get a free trip to the hospital. He managed to swallow down a soda can on one occasion, but the most amazing thing he ever ingested was—-a sneaker!

    So, no ruptured viscus, but possible “athlete’s stomach”…

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