Homeland security reaches the anus | Lancet | 2.3.07
I wish to bring to your attention difficulties one of my patients recently encountered when entering the USA. He is a 48-year-old man with a fistula-in-ano managed with a long-term seton to control perianal sepsis.
A seton consists of a length of suture material knotted to form a loop which lies in the fistula track. It passes through the fistula, out of the external opening beside the anus, into the anus, and re-enters the fistula through the internal opening. Various different materials can be used; in this case the seton was made of a turquoise braided synthetic suture.
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The patient was refused entry into the country unless the seton was removed. Given the somewhat stark choice, he chose removal of the seton, which was done by a doctor at the airport who claimed never to have come across one before. The patient now requires an examination under general anaesthetic to insert a replacement.
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I’m sorry, of course I meant “your anus and home-end security…” The patient’s attorney could not be reached for comment—she has to finish drinking her breast milk.