A teenager had his penis ripped off by a shark as he swam with friends near a beach.
Horrified holidaymakers rushed to the young man's aid and pulled him from the sea as the terrifying attack unfolded.
The shark struck as lifeguards told Jose Ernestor da Silva to come closer to the shore, according to reports.
Footage shows rescuers carrying the 18-year-old onto Piedade beach near Recife, Brazil.
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They try to stem the blood by tying garments around the wound, while others can be heard tell the clearly stunned teenager to “breathe”.
An ambulance rushed Jose to hospital, where he reportedly suffered two heart attacks and is in a critical condition.
Despite undergoing emergency surgery, his penis and femur were “amputated” by the bite of what is believed to be a tiger shark, according to medics.
Rodrigo Matias, from Recife’s fire department, said the victim was swimming with his brother and friends in deep waters near the shore, in an area marked by signs warning of shark attacks.
Seeing that the group was drifting further out, lifeguards called for them to return to shallower waters.
He said: “At the exact moment in which the lifeguards asked for them to come closer to the beach, he was bitten.”
Ambulance medic Wagner Monteiro said Jose had a heart attack after arriving at the local Aeronautica Hospital, and another as he was being transported to the Restauracao Hospital in the centre of Recife.
He said: “The shark bite amputated his femur and his penis. He lost a lot of blood and is in a critical condition.”
A spokesman for the Restauracao Hospital said Jose was rushed into surgery after arriving at the hospital at 5.53pm. Doctors will give a report on his condition later Monday.
Jose’s mother Elisangela dos Anjos, 42, told Brazil’s JC Online that he had gone to the beach without her knowing, and she only knew about after his his brother Ezequiel, who was with him, called her from the beach following the attack.
Speaking from the hospital, she said: “He would go in secret, because he knew that I thought it was dangerous. I wasn’t worried because I thought he was somewhere around the house.
“When I heard about it I went crazy, all the neighbours heard me screaming.”
It is the second time in less than two months that a shark attack has left a swimmer in a critical condition at the same beach in the Jabotao de Guararapes district of greater Recife.