After a man attempted to smuggle a small amount of marijuana inside a balloon stuffed in his nose into prison, he thought he accidentally swallowed it and that the cannabis ended up passing through his body.

But that turned out not to be the case, because 18 years later doctors inadvertently discovered the marijuana—calcified in his right nostril—during a head scan.

The odd occurrence was highlighted in a report published in the journal BMJ Case Reports last week. Doctors said the patient presented with the rhinolith, which is essentially a stone lodged in the nasal cavity that can develop internally or through external factors like a child sticking a Lego in their nose.

But this incident proved unique and caught the attention of the medical journal. A 48-year-old man went to the hospital for a CT scan after complaining of headaches and, upon questioning, said that he had a history of nasal obstruction and infections. The scan turned up a 19mm by 11mm rhinolith, which was then removed endoscopically.

“The histopathology report noted a ‘rubber capsule containing degenerate vegetable/plant matter,’” doctors from Westmead Hospital in Sydney, Australia wrote. “On follow-up and specific questioning, the patient was able to recall an incident that occurred 18 years prior, while he was incarcerated.”

“During a prison visit, the patient’s girlfriend supplied him with a small quantity of marijuana, inside a rubber balloon. In order to evade detection, the patient inserted the package inside his right nostril,” they continued. “Despite effectively smuggling the package past the prison guards, the patient then accidentally pushed the package deeper into his nostril and mistakenly believed he had swallowed it. He remained unaware of the package’s presence until presented with the unusual histopathology report.”

The patient checked back in with the doctors three months after the rhinolith was removed and reported that the nasal issues had gone away.

The case report emphasizes that rhinoliths are generally rare, accounting for an estimated 1 in 10,000 nose doctor outpatient visits. It’s possible that the number may be higher, as many instances do not present symptoms but, generally speaking, it’s uncommon.

The 18-year-old marijuana shoved into the nose of a formerly incarcerated person that subsequently calcified is a next-level medical finding, the doctors said.

“To the best of our knowledge, our case represents the first report of a prison-acquired marijuana-based rhinolith,” they wrote.

The medical team speculates that the reason doctors don’t see more cases of prison-related rhinoliths is because most smuggling attempts “involve ingestion of the foreign body that acts as a bezoar to be retrieved after passage through the gastrointestinal tract, while insertion into the nasal cavity for this purpose is relatively rare.”

“Nevertheless, an index of suspicion of rhinolith should be maintained in all cases of unilateral nasal symptoms,” they concluded.

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