 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. 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. 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. 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. "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.
– 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.)