Razor blades, a wrist watch and a metal rod are just some of the items prisoners in Northern Ireland have swallowed — as these shocking pictures show.
A study published in the Ulster Medical Journal has revealed that 11 inmates — eight men and three women — had to receive hospital treatment after ingesting a bizarre range of foreign bodies.
Also among the items medically removed were batteries, some of which were swallowed six-at-a-time, and a 20 pence coin.
Case notes from doctors at Belfast City Hospital, Northern Ireland's only designated prisoner hospital, showed the foreign bodies were consumed by prisoners between March 1998 and June 2007.
Of the 11 patients, three required surgery in the form of a laparotomy, an incision through the abdominal wall; a further two required endoscopic intervention, a camera inserted into their body to examine the oesophagus, stomach and the first part of the small intestine, and two others needed both endoscopic and open removal of the item. Miraculously, none of the prisoners died.
Watch this: timepiece removed from intestines of female prisoner
The study has also revealed that 36% of prisoners repeated the potentially lethal ingestion. Indeed, one male prisoner who swallowed razor blades was returned to hospital some time later to have more blades and a metal rod removed.
One woman who admitted to intentionally swallowing a wrist watch spend four days in hospital recovering. It is understood the watch had been in her body for six weeks before she was presented for treatment. Amazingly the watch was still working when it was removed.
Professor Patrick Morrison, from the Ulster Medical Journal, said: " This article is really interesting. It's completely bizarre what some people will swallow in a confined space."
Inside story: 20 pence was found in one inmate's innards
The motives behind the ingestion varied from psychiatric conditions to genuine accidental consumption.
The study said: "The motives behind the ingestion are variable. As the only designated hospital in Northern Ireland treating acute surgical pathologies in the prison population, we reviewed our experience of foreign body ingestion between March 1998 and June 2007.
"Types of foreign objects, syptomatology, haematological analyses, radiological findings, operative intervention and complications were retrieved from case notes.
"Underlying psychiatric conditions, attempts to escape incarceration by transfer to a hospital or psychiatric unit, genuine accidental ingestion and attempts at drug trafficking are common motives.
"The prison population is a unique environment with different emotional and physical constraints where both the nature and motives behind ingestion are ambiguous with further difficulties encountered in the diagnosis and management of such patients."
Barred: A metal rod swallowed by one of the convicts