Sir, that’s not my colon: Journal has a bite of a chicken and egg problem

Case report: An 85-year-old man eats some chicken and unknowingly swallows a bone. After two days of worsening abdominal pain, he shows up to the emergency room. A CT scan reveals the bone perforating his colon. He is rushed to surgery, which is successful. Then, during his otherwise uneventful recovery, he develops female breasts.

That’s not exactly the case report that showed up in the International Journal of Surgical Case Reports earlier this month, but then again, the images in the relevant case report aren’t exactly of someone’s colon, either.

With a warning that the clinical images below are mildly NSFW, here’s Figure 1 from the cleverly titled “Chicken or the leg: Sigmoid colon perforation by ingested poultry fibula proximal to an occult malignancy:”

Fig. 1. CT scan of abdomen and pelvis showing radio-dense bony foreign body perforating through the sigmoid colon (red arrow). Flecks of free intra-peritoneal air can be seen (yellow arrows).

Now, the one of us who went to medical school — Ivan — wasn’t exactly a gross anatomy rock star, but we’re fairly certain that Figure 1 is neither a CT scan nor any kind of depiction of the sigmoid colon.

Figure 2 is labeled

Fig. 2. Pathology specimen images demonstrating perforation of a chicken bone through the sigmoid colon immediately proximal to a stenosing malignant lesion. (A) Chicken bone in situ with the broad and in the lumen and narrow end penetrating the serosal surface. (B) Chicken bone after removal. (C) Serial macroscopic sections of distal sigmoid colon showing luminal stenosing malignancy.

However, it appears to show radiological images of a breast, perhaps one of those shown in Figure 1:

The errors are repeated in the PDF version of the case report. As it turns out, however, the “accepted manuscript” version of the PDF, available on the journal’s own site instead of Elsevier’s ScienceDirect, has the correct figures.

John Terrace, the corresponding author of the case report, tells us:

Yes – the publisher has made an uncorrected proof available online with the wrong figures. I noticed this immediately, informed the journal and I am told this issue is being addressed. This is obviously embarrassing for the journal. Presumably there is another case report currently in proof form with my figures!

Incidentally, we were introduced to the International Journal of Surgical Case Reports by Metro, which covered one of its papers in a story headlined “Pensioner has fork removed from penis by surgeons after sexual play.” Click on that link, but be warned that your mind will never be able to un-see that X-ray.