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." ||||| Welcome!Hello everyone. I just want to thank you for giving your time to read our story and to understand what our family and my twins have been going through so that maybe this can have an impact on somebody else and maybe help them with their future illnesses they may have. This is a journey of their health and wellness, spiritual needs and everything else that will come along the way. I will be posting quite frequently, giving updates on the boys and what's going on in their daily lives as they endure their battle with what's called "cirrhosis of the liver" from a genetic mutation that they found. The cirrhosis is not from the commonly known factors that would typically cause cirrhosis of the liver. This is strictly from a mutated gene found in the boy's DNA during its splitting, and somehow this gene is believed to have caused several symptoms and issues, and we are still trying to figure it out with the help of a genetics doctor.Nicholas and Devin were born October 20th, 1999 as healthy identical twin boys, who were beautiful baby boys. They were a blessing to me when I found out during the ultrasound that I was going to have twins, as my mother has also had twins, so don't necessarily believe in the myth that it skips a generation because it doesn't! Haha.Through the years they have been healthy for the most part besides getting head colds, strep throat and common childhood illnesses that kids get. The diagnosis of liver disease began when Nicholas called me from school complaining of his hamstring burning so bad that he could hardly sit in his school desk. He complained about it throughout that night, and I told him it may be just growing pains as my boys were growing inches like crazy. Now they're 5'10"! As we brushed it off as maybe being just growing pains, the following day he called me again in tears and that it was so severe he couldn't stand it any longer. I left work and brought him to the emergency room . The ER Doctor ran blood work and saw that he had platelets that were really low, but he didn't understand if that was a correlation with the hamstring burning. We were then referred to see a Hema-Oncologist at Children's Hospital for a follow-up. You can imagine the scare that I had when I had a doctor tell me to see a Hema-Oncologist. I instantly thought blood cancer. I had no idea that that would eventually become a reality much later down the line. I told the doctor that I had identical boys and he said I should have his brother checked too. We went to their pediatrician and Devin's CBC showed a low platelet count in the 40,000 range. Normally platelets range 150,000 to 450,000. We knew there was something wrong.After numerous trips to Children's hospital seeing different specialist, we were referred to a liver doctor at Ochsner in Jefferson, LA. Both Nicholas and Devin were scheduled for an ultrasound of the abdomen and that is when they saw some problems with the liver being abnormal with nodular growths throughout. The liver had been compensating, for the lack of, over a long period of time and grew extra vessels and nodules to help the blood flow. Their spleen grew twice it's size to compensate for the lack of the liver function. Following the ultrasound they did a cat-scan and saw more extensive issues and decided to set them up for a liver biopsy. Both boys went in to have this liver biopsy in March 2017, and were found to have severe scar tissue on the liver, followed by the diagnosis of cirrhosis of the liver.It has been brought to mind that this has been occurring for a long period of time because it takes a long time for the liver to get scarred, but this was something that we didn't even know was happening. All of this was brought about just by Nick having blood work done due to the burning in his hamstrings. Something that could have been totally unrelated. So from there they were scheduled every two months for blood work, (CBC), keeping an eye on their liver enzymes, platelets, etc. Everything was going "good" until one night Nick came in from work, where he was working a part-time job at Sonic after school, and he came in bent over in excruciating pain. I knew something was wrong and rushed him to the ER. They did a cat-scan and blood work, eased his pain, and felt it was best that he get transferred by ambulance to Oschner in Jefferson where his liver doctors were so that they can follow up his care. From there, he was admitted for one week to observe, run test after test, and try to find what was causing his abdomen to be in excruciating pain. After another ultrasound and an MRI, they found suspicious lesions, one measuring 10cm, on his liver that had grown over a period from March to August and needed to do another liver biopsy. This was such a fast growth and not seen in previous scans. I will never forget August 31st, 2017, when I was told that Nick was diagnosed with Angiosarcoma, cancer of the inner lining of the blood vessels. A very rare, incurable, aggressive cancer that formed in his liver. I felt like my whole world had changed in that moment. So many questions were rushing through my mind and I didn't know the severity of what he had but all I knew is that my son, a healthy young twin boy, is now battling cancer on top of cirrhosis of the liver. What do I do now? How do I accept this? Why God, why? All of these questions and so many others flew through my mind. From feeling angry. To bitterness. Why him? I cried and cried and it was all I could do to not collapse to my knees completely overtaken with emotion. But I knew I had to hold strong for my son, even as hard as that was. To have all of your emotions bottled up but to hold back sharing it with your son, hoping to show strength and reassurance. Hoping to show him this isn't the end, everything will be okay, but deep in my heart, I knew it was bad. Nick is now sitting there in the hospital bed, after being hospitalized for a full week, having a biopsy, undergoing test after test, probe after probe, doctor after doctor. Observations, conversations, and now results that sent his world crashing in on him. A high school spenior with a multitude of possibilities ahead. I remember the doctor walking in and explaining to our family the type of cancer that he has and told Nick, "Nick, what is it that you want to do right now in the near future?" And Nick said, "I want to walk across that stage and graduate." The doctor then said, "I will see to it that that happens as best as possible." It's sometimes little things like that that mean the most to someone that was just given a terminal disease and a death sentence. I cannot even imagine what was running through my 17 year old's mind at that time. But I do know that as a mother, I have to give these boys strength, give them hope and give them courage to overcome. I have always been the strength in the family and the boys continue to expect me to be that way. I am their solid rock and as Nick told me the other day, I am his best friend. Words spoken through his pain that meant a lot a mother. Thank you all for following along on our journey of trials, truth and triumph. We are going to stand and fight, and we know God is with us every step of the way. 
 
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– 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.)