A Florida man’s mysterious abdominal pain was the least of his doctors’ concerns after they discovered an 8-inch screwdriver in his rectum.

The unnamed 46-year-old man had suffered a near-fatal punctured bowel, resulting in septic shock that sent him to ER, according to the case report published in the Annals of Medicine and Surgery.

It took a CT scan to find out what was responsible for his symptoms, including pain through his abdomen and pelvis, his doctors from the Kendall Regional Medical Center in Miami wrote.

Sepsis had decayed part of the man’s buttocks, which had to be removed to eliminate the source of the infection. His medical records showed a history of mental illness, including schizophrenia and bipolar disorder. The man reportedly failed to take his medication, the report said. He was later treated for psychiatric distress.

After X-rays revealed the foreign object, the man was immediately administered antibiotics and rushed to the operating room where doctors attempted to remove the screwdriver without surgery. But hardened human waste made retrieval impossible, so surgeons were forced to cut into the man’s abdominal cavity. There they discovered that the metal tip had perforated his large intestine and dug itself into the buttock muscle.

With his rectum disabled, surgery was performed to direct waste into a bag outside of his body, though doctors said in their report that an “ostomy reversal” had been scheduled.

“At two weeks follow up the patient was doing well,” the authors, led by Dr. Youssef Shaban, wrote. “The patient recovered and was discharged to Behavioral Health for inpatient treatment of his psychiatric disorders.”

The study added that there have been at least two previously documented cases of “screwdrivers … discovered in the colon,” one of which led to death.

Doctors at Kendall Regional did not report on the man’s explanation for inserting a screwdriver into his behind, but in their report, Dr. Shaban wrote, “The most common reason, by far, for anal foreign body insertion is sexual pleasure.”

He went on to suggest other possible reasons, such as “drug concealment, assault, ‘accidental,’ psychiatric reasons [or] to alleviate diarrhea or constipation.”

“The patient may not be forthcoming initially with the critical information as it may be an embarrassing situation,” he added.