Ingestion of Bell Clappers by a Shaman in Jumla, Nepal: A Case Report

Muna Maharjan,Niresh Thapa,Subi Basnyat

doi:10.31729/jnma.4055

Abstract

Accidental foreign body ingestion is a common problem encountered in Emergency. Deliberate foreign body ingestion may result due to an act of insanity or an act of daring. A shaman locally known as Dhami was brought to Emergency with the history of ingestion of bell clappers. He denied the history of psychiatric illness or substance abuse. On physical examination, there were signs of peritonitis. Laparotomy was done to remove the foreign bodies. Post-operative period was uneventful. Apart from the surgical intervention, psychological counselling was given to him. This is a rare interesting case due to the fact that the 15 cm long foreign bodies passing all the way through without significant injury and finally causing obstruction in ileocecal junction and perforation in the distal ileum. Keywords: foreign bodies; Nepal; shaman.

Highlights

Accidental foreign body (FB) ingestion is a common problem encountered in Emergency, but it can occur in a patient with a psychiatric illness or other issues
Bell is regarded as the holy object in a temple, so the shaman who ingests bell clappers was believed to be near to the god and people trust him more
He has been ingesting bell clappers for years without any complications which he successfully ‘digested’. This time it was complicated because of the alcohol he consumed and the ‘touch’ by lower caste during his pray. This case has indicated that even in the modern age of Nepal, there is shaman active in some parts of Nepal practising as a traditional healer

Summary

Introduction

Accidental foreign body (FB) ingestion is a common problem encountered in Emergency, but it can occur in a patient with a psychiatric illness or other issues.1 Deliberate FB ingestion may result due to an act of insanity.2 Here we report a rare case of ‘shaman’ (or ‘Dhami’ in the Nepali language). He had given the history of ingesting 4-5 bell clappers and alcohol 60 days earlier on the special occasion of full moon day.

Results

Conclusion