Sheathing troubles: The strange case of accidental condom inhalation

While researching a previous blog on condom snorting, I came across an interesting case study of ‘accidental condom inhalation’ (and no, I promise I am not making this up). The case dates back to 2004 and was published by Dr. C.L. Arya and colleagues in the Indian Journal of Chest Diseases and Allied Sciences (IJCDAS).

Anyone who has kids will know that (just out of curiosity) they commonly put things in their mouths. The IJCDAS paper made reference to a number of medical studies that have shown inhaled items include things that can be from the edible (nuts, seeds, beans, etc) to the non-edible (plastic objects, screws, needles, pins, etc). They also note that when inhaling such objects, it doesn’t always lead to immediate medical symptoms or complications (such as choking, wheezing, coughing, etc.). However, the case that Dr. Arya and colleagues reported on was a little out of the ordinary.

The case involved a 27-year-old woman who was a schoolteacher. For a six-month period she had been suffering from a persistent cough where she was coughing up mucus along with some pneumonia symptoms. Initial examination showed nothing of consequence. Further tests took place and the paper reported that:

“The chest radiographs carried out subsequently showed development of a non-homogeneous right upper lobe lesion, not resolving either with antibiotics or a four-month trial of an empirical anti-tuberculosis treatment instituted by various practitioners. No symptomatic relief was obtained with either therapy. [A later] chest radiograph demonstrated a right upper lobe collapse-consolidation of lung. The opacity led us to promptly carry out a video-bronchoscopy, which gave impression of a white membranous object protruding from the collapsed right upper lobe bronchus. On probing further, it was noticed to be an inverted bag-like structure ‘sitting’ in the bronchus and having a flap-like action. A rigid bronchoscopy was then performed and the object was easily removed with biopsy forceps, though, it tore into pieces during procedure”.

As you will have noted from the title of this blog, the pieces were identified as being from a condom. The woman and her husband eventually recalled to the medics (after much probing by the medics) that there was an incident that occurred where a condom had become loosened while the wife was performing oral sex on her husband. During this particular sexual act, the woman had experienced a bout of coughing and sneezing and without her knowing she had accidentally inhaled her husband’s condom.

One of the reasons that the accidental inhalation went unnoticed for so long was because the inhaled object was of “soft, elastic and rubbery consistency that [was] unlikely to cause a direct lung injury”. The authors noted that:

“The airway obstruction of the right upper lobe segments produced by [the condom], could have resulted in the retention of secretions and the infection of corresponding lung segments, which may have become radiologically visible as a non-homogeneous right upper lobe collapse-consolidation. Despite mechanical obstruction, the flap-like action of condom (as noticeable on video-bronchoscopy) probably continued to clear secretions from right upper lobe, contributing to the delay in radiologic presentation of case”.

The medics were unsure whether the woman had genuinely accidentally swallowed the condom or whether she was just too embarrassed to report the incident and/or didn’t relate the incident to her subsequent symptoms. The authors also claimed that the original physicians who examined the woman were responsible for the condition being prolonged as they had failed to suspect that a foreign object (i.e., a condom) was the cause of the non-resolved pneumonia. They then noted that:

“Perhaps, views of physicians were guided by the age of patient (that was less suited for a suspicion of an inhaled foreign body), and also the fact, that a disease like tuberculosis was so highly prevalent in this part of world that a preference for the institution of [anti-tuberculosis treatment] was quite natural”.

Together, all of these reasons are likely to have resulted in a delayed diagnosis. The authors also noted that:

“Even following the condom retrieval [both husband and wife] were understandably hesitant in disclosing it owing to the nature of affair concerned (involving one’s privacy), the unusual nature of coitus performed (via an oral route) and the inhalation of a discrete object (like condom). The possibility of seminal aspiration also taking place simultaneously may not be ruled out…The case has certain atypical features, of which, the foremost relates to the type of inhaled object, i.e., a condom, which has not been reported in the literature to the best of our knowledge…[Another] atypical feature was adult-age of patient, that by any means, would be least expected to be associated with any foreign body inhalation”.

The authors speculated as to whether this incident was a one-off or whether such incidents were more widespread and were being under-reported because the Indian sub-continent has “a traditional conservative culture” where “people tend to have religious attitudes and sex is largely considered to be a subject limited to a person’s private life”. The authors concluded that:

“Perhaps, the young lady in our case was also quite apprehensive about fellatio, a fact that could have played a part in the condom inhalation. It is much desirable that sex taboos prevalent on the sub-continent are curbed and greater sexual awareness created in the people’s minds”.

Dr Mark Griffiths, Professor of Gambling Studies, International Gaming Research Unit, Nottingham Trent University, Nottingham, UK 

Further reading

Agarwal, R.K., Banerjee, G., Shembish, N., & Jamal, B.A., Kareemullah, C. & Swaleh, A. (1988). Foreign bodies in the tracheobronchial tree: A review of 102 cases in Benghazi, Libya. Annals of Tropical Paediatrics, 8, 213-16.

Arya, C.L., Gupta, R. & Arora, V.K. (2004). Accidental condom inhalation. Indian Journal of Chest Diseases and Allied Sciences, 46, 55-58.

Ben-Dov, I. & Aelony, Y. (1989). Foreign body aspiration in the adult: An occult cause of chronic pulmonary symptoms. Postgraduate Medical Journal, 65, 299-301.

Causey, A.L., Talton, D.S., Miller, R.C., Warren, E.T. (1997). Aspirated safety pin requiring thoracotomy: Report of a case and review. Pediatric Emergency Care, 13, 397-400.

Lyons, D.J., McClod, D., Prichard, J., Dowd, D., & Clancy L. (1993). Very long retention of bronchial foreign bodies: Two new cases and a review of the literature. Irish Medical Journal, 86, 74-75.

Murthy, P.S., Ingle, V.S., George, E., Ramakrishna S. & Shah, F.A. (2001). Sharp foreign bodies in the tracheobronchial tree. American Journal of Otolaryngology, 22, 154-56.

About drmarkgriffiths

Professor MARK GRIFFITHS, BSc, PhD, CPsychol, PGDipHE, FBPsS, FRSA, AcSS. Dr. Mark Griffiths is a Chartered Psychologist and Professor of Behavioural Addiction at the Nottingham Trent University, and Director of the International Gaming Research Unit. He is internationally known for his work into gambling and gaming addictions and has won many awards including the American 1994 John Rosecrance Research Prize for “outstanding scholarly contributions to the field of gambling research”, the 1998 European CELEJ Prize for best paper on gambling, the 2003 Canadian International Excellence Award for “outstanding contributions to the prevention of problem gambling and the practice of responsible gambling” and a North American 2006 Lifetime Achievement Award For Contributions To The Field Of Youth Gambling “in recognition of his dedication, leadership, and pioneering contributions to the field of youth gambling”. His most recent award is the 2013 Lifetime Research Award from the US National Council on Problem Gambling. He has published over 600 research papers, four books, over 130 book chapters, and over 1000 other articles. He has served on numerous national and international committees (e.g. BPS Council, BPS Social Psychology Section, Society for the Study of Gambling, Gamblers Anonymous General Services Board, National Council on Gambling etc.) and is a former National Chair of Gamcare. He also does a lot of freelance journalism and has appeared on over 2000 radio and television programmes since 1988. In 2004 he was awarded the Joseph Lister Prize for Social Sciences by the British Association for the Advancement of Science for being one of the UK’s “outstanding scientific communicators”. His awards also include the 2006 Excellence in the Teaching of Psychology Award by the British Psychological Society and the British Psychological Society Fellowship Award for “exceptional contributions to psychology”.

Posted on December 4, 2013, in Case Studies, Eating disorders, Pica, Psychology, Sex and tagged , , , , , . Bookmark the permalink. Leave a comment.

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