A game of paintball had an unfortunate ending when a teen in England wound up needing liver surgery after being struck in the abdomen, according to a new report of the young man's case. 
 
 The injury was the first instance of a person suffering liver damage from playing paintball, the doctors who treated the teen wrote in their report of his case, published May 5 in the journal BMJ Case Reports. 
 
 The 18-year-old went to the emergency room in August 2015 because of abdominal pain and a low-grade fever, said Dr. Joshua Luck, a resident surgeon at North Middlesex University Hospital in London, who treated the patient and is the lead author of the case report. 
 
 Based on the patient's symptoms, the doctors there diagnosed him with appendicitis. (He hadn't mentioned to the doctors that he had played paintball two days prior.) They scheduled him to have emergency surgery, according to the report. [Costly, Deadly, Complicated: These 7 Surgeries Take the Biggest Toll] 
 
 But when the operation began, the doctors were "very surprised to see blood coming from the liver," Luck told Live Science. The doctors even thought that they might have injured a blood vessel during the operation, because the blood in the abdominal cavity was so unexpected, he added. However, they then realized that the problem was the man's liver, not his appendix. 
 
 They stopped the bleeding, and after the operation, learned that the man had been playing paintball two days earlier, and had been hit twice in the abdomen, according to the report. 
 
 The doctors were surprised to learn that the liver damage most likely resulted from the paintball incident, especially because the man had no bruises on his skin near the liver, Luck said. He noted, however, that it is not uncommon for "seemingly innocuous events to cause internal injuries." 
 
 In addition, traumatic injuries can lead to symptoms such as fever, Luck said. 
 
 Two days after the man's surgery, the doctors checked to make sure the bleeding had definitely stopped, and the man was allowed to leave the hospital, according to the report. 
 
 However, three weeks later, the young man returned. He told the doctors that he had undergone an ultrasound, which showed that there was still blood pooled in the liver, according to the report. 
 
 This worried the doctors — they thought the teen might have reinjured his liver, or that the original injury was still bleeding, Luck said. However, further testing showed that no further damage had occurred, and indeed, the body was slowing reabsorbing the pooled blood, he said. In addition, the man's liver was functioning well, he said. 
 
 "In the vast majority of blunt liver injuries, the body is able to heal itself over a period of weeks to months without the need for further" medical assistance, Luck said. But sometimes, the healing may be slower than expected, he added. 
 
 And in some cases, slow healing of this type of injury may be due to a blood disorder that causes the blood to not coagulate normally, Luck said. However, doctors who specialize in blood disorders confirmed that this was not the case for this man, he said. [7 Strange Ways Humans Act Like Vampires] 
 
 While the young man's injury was the first instance of liver damage from paintball, it's far from the first injury from the activity — eye injuries, for example, are common. It is, however, only the fourth case of organ damage from paintball, the authors wrote. There has been one previous case of kidney damage from paintball, and two cases that involved damage to the penis or scrotum, according to the report. 
 
 Paintball guns can fire the paintballs at velocities of 100 to 300 feet (30 to 90 meters) per second, according to the report. 
 
 This was the young man's first time playing paintball, Luck said. "Whether he'll try it again is yet to be decided," he said. 
 
 Currently, the young man is doing well and continuing with his college studies, Luck said. 
 
 Follow Sara G. Miller on Twitter @saragmiller. Follow Live Science @livescience, Facebook & Google+. Originally published on Live Science. ||||| An 18-year-old man thought to have appendicitis ended up being treated for severe internal injuries after an intense paintball game, according to a new case study. 
 
 The unidentified patient came in with severe abdominal pain, no appetite and fever, which is consistent with appendicitis, according to the case study published today in the BMJ medical journal by doctors from University Hospital in London. 
 
 However, after the teen was rushed to the operating room, doctors found that his appendix wasn't the problem and that his liver was lacerated and bleeding into his abdomen. Doctors were able to stop the bleeding by "repacking" the liver or applying a special pad and putting pressure on the organ overnight. The liver had to be repacked again the next day until the bleeding finally stopped. 
 
 After interviewing the patient, doctors discovered he had taken part in a paintball game two days before and reported being hit twice on his lower right-hand side, according to the case study. 
 
 "This represents the first report of paintball-related blunt traumatic injury to the liver," the doctors wrote in the study. "Solid organ injuries of this nature have only been reported three times previously." None of those cases involved liver damage. 
 
 The doctors pointed out that paintball pellets have caused serious injuries in the past. 
 
 "Pellets with muzzle velocities of 100–300 feet per second are potentially harmful to ocular structures and also to the intra-abdominal solid organs," the authors said. "Participants and physicians must both be aware of the possible dangers associated with this recreational sport." ||||| This story is part of a partnership between MedPage Today and VICE News. 
 
 If you find yourself alone this Valentine's Day, we have a gift for you: knowledge that it could always be worse. Like way, way worse. 
 
 A 17-year-old man presented to the emergency room with abdominal pain and a foreign body in his anus. He told doctors he had inserted a pencil into his rectum and then had anal sex with the pencil still in there. He was treated and released. 
 
 The man's case is one of nearly 450 sex injuries found over six years in the National Electronic Injury Surveillance System (NEISS), which is compiled by the federal Consumer Product Safety Commission. 
 
 "It's not uncommon that we see this, but it's not a daily occurrence," emergency physician Dr. Robert Glatter, of Lenox Hill Hospital in New York City, said of sex-related injuries. "We've had a woman with a head injury and fractured cervical spine, who basically ended up going forward into a headboard. She was very dizzy at the time and was on top of this gentleman lurching forward into a headboard." 
 
 In another sex injury in the database, a 62-year-old man sustained a penile crushing injury after putting homemade PCVP pipe rings and the ring off a horse halter around his penis. He, too, was treated and released. 
 
 Most of the sex injuries involved foreign objects used for pleasure that disappeared and got stuck in certain orifices, according to the data. Objects included vibrators and other sex toys as well as some other objects, including a "spikey (sic) rubber ball that lights up," a screwdriver, the handle of a toilet plunger, and a pool ball. 
 
 Sometimes, patients waited several days before going to the emergency room to have these objects removed. 
 
 "We see a ton of these. Patients delay and sometimes don't come in for a few days," Glatter said, explaining that perforation can occur with catastrophic results. "The longer you wait, sometimes you can even get septic." 
 
 Other sex injuries in the federal database included sprains and fractures, concussions, lacerations and conditions like syncope, in which the blood pressure drops rapidly and the person loses consciousness. None of the injuries were fatal, and most patients were treated and released. 
 
 Glatter said patients shouldn't wait to go to the emergency room, even if they're embarrassed. 
 
 "We always have respect and privacy and never pass any judgement," Glatter said. "We want to make sure they're OK. I think that's what contributes to delays — fear staff will react in a negative way." 
 
 Most sex-related injuries affected the lower trunk and pubic regeon, but others included the head, neck and even mouth. 
 
 A 19-year-old woman sustained a sex-related dental injury after her "sex swing" fell out of the ceiling and she hit her mouth. 
 
 Although these injuries account for less than .02% of the 2.3 million reported injuries from 2009 through 2014, most sex-related injuries never get reported, experts say. 
 
 Pepper Schwartz, PhD, of the University of Washington, said most of these injuries stay under the radar because patients try to avoid the emergency room. Schwartz, a sociologist who specializes in sex, added that the stress of an intercourse injury can bring couples together or tear them apart. 
 
 "The important thing is not to let yourself panic," she said, stressing that the vagina and the anus are not cut off from the rest of the body and sex injuries can have serious consequences. "Get it fixed." 
 
 The database does not include penile injuries related to drugs like Viagra and Cialis, which Glatter said are also common. Adverse events from using medications would not be expected to appear in this data, and would instead appear in a Food and Drug Administration database. 
 
 Glatter added that alcohol and mood-altering drugs often also play a role in sex-related emergency room visits. 
 
 Valentine's Day is this month, but February actually not the top month for sex injuries, according to the data. That month is July. 
 
 Photo via Vivatier
– When an 18-year-old arrived at a London emergency room with severe abdominal pain, no appetite, and a fever, doctors recognized the symptoms of appendicitis and scheduled an emergency surgery. They were in for a shock. Once the teen had been cut open, doctors at North Middlesex University Hospital were "very surprised to see blood coming from the liver," while his appendix seemed just fine, Dr. Joshua Luck tells Live Science. They were so surprised, in fact, that they thought they might have nicked a blood vessel. What the teen had failed to mention: Two days earlier he'd been hit in the abdomen by two paintballs during his first attempt at the sport, reports ABC News. Though the paintballs—which can travel up to 300 feet per second—didn't leave a bruise near his liver, it's not uncommon for "seemingly innocuous events to cause internal injuries," Luck says. The August 2015 incident "represents the first report of paintball-related blunt traumatic injury to the liver," researchers explain in BMJ Case Reports. While eye injuries are from paintball are "well recognized," solid organ damage from paintballs has only been reported in three prior cases: one involving the kidney and two involving the penis/scrotum. Doctors were able to stop the bleeding and confirmed weeks later that the teen's liver was functioning well. "Whether he'll try (paintball) again is yet to be decided," Luck says. (This guy burst his bladder in an odd way.)