Abstract
Anorectal foreign body (FB) is a form of anorectal trauma with increasing incidence. The most common cause is anal eroticism. Presentation is usually delayed. Gentle and careful clinical-radiological evaluation are warranted for diagnosis, characterization of FB, detection of complication, and planning the removal. Transanal removal is successful in most cases. Various instruments, endoscopy, and minimally invasive techniques are options. Operative approach is preserved for correction of complication; colonic obstruction, bleeding, perforation, internal fistula, failure of progression of ingested FB to anus and presence of “body pusher syndrome.” Anorectal trauma is approached systematically by the Advanced Trauma Life Support principles. Accessible rectal injury site can be primarily repair with or without proximal diversion. Extraperitoneal rectal injury, where not easily accessible, requires proximal diversion and presacral drainage. Distal rectal washout is performed for destructive wounds. Anal sphincter and perineal injury should be thoroughly evaluated and repaired later when other life-threatening conditions have resolved.
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