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May 5, 2016 6:30 PM EDT

Doctors are reporting what appears to be the first case of a man receiving a blunt traumatic injury to his liver because of playing paintball.

In the case report, published in the journal BMJ Case Reports, researchers chronicle a case of an 18-year-old man who was admitted to a hospital for what was believed to be appendicitis. As it turned out, doctors observed bleeding from his liver.

It was discovered that the man had played paintball a couple days earlier and had been hit more than once in that region of his body. The man was able to be treated, but required an operation to stop the bleeding. “Solid organ injuries of this nature have only been reported three times previously—all in the urological setting,” the report authors write.

“Paintball pellets are known to be harmful to ocular structures but are increasingly associated with vascular and solid organ injuries,” the report authors warn. “Participants and physicians must both be aware of the possible dangers associated with this recreational sport.”

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