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Images in emergency medicine
Yubitsume (self-amputation)
  1. T Abe1,
  2. Y Tokuda2,
  3. S Ishimatsu1
  1. 1
    Department of Emergency and Critical Care Medicine, St Luke’s International Hospital, Tokyo, Japan
  2. 2
    Clinical Practice Evaluation and Research Center, St Luke’s Life Science Institute, Tokyo, Japan
  1. Dr T Abe, Department of Emergency and Critical Care Medicine, St Luke’s International Hospital, 9-1 Akashi-cho, Chuo-city, Tokyo 104-8560, Japan; abetoshikazu{at}mac.com

https://doi.org/10.1136/emj.2007.056432

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    THE LEGEND

    A 51-year-old man presented to the emergency department with self-amputation of his left little finger. He was a member of the yakuza (Japanese Mafia organisation). He amputated the little finger himself at the distal phalanx with a knife and swallowed the amputated finger before arrival at the hospital. His little finger was repaired without connection of the amputated portion. Self-amputation of a finger in a yakuza member is called Yubitsume, and this ritual is used as an apology for disobedience to the organisation. The reason for Yubitsume in this patient was that he wanted to resign his yakuza membership and thus he needed to apologise to the other members. Since he was required to show that he did not intend to reconstruct his finger, he swallowed the amputated finger. Japanese physicians sometimes encounter patients with Yubitsume in an emergency department.

    Figure 1
    Figure 1 Radiograph showing amputated little finger.

    Footnotes

    • Competing interests: None declared.

    • Patient consent: Obtained.