DIFFERENTIATED TREATMENT TACTICS IN PATIENTS WITH RECTAL FOREIGN BODIES

Abstract

Summary. Patients with rectal foreign body (RFB) are quite rare in the practice of emergency surgeons. There are different techniques for deleting RFB depending on the features of the object being entered. There is still no standardized protocol for the surgical treatment of such patients.
 Aim. To analyze the immediate and long-term results of treatment of patients with RFB. Introduce differentiated therapeutic tactics into the practice of urgent surgeons depending on the characteristics of the foreign body and the presence of complications.
 Materials and research methods. Three patients with RFB were treated in the surgical department of SRCH during 2018-2019. Their average age was (38 ± 3.6) years. The algorithm of the examination consisted of a physical examination, a rectal finger examination, a radiological and a laboratory examination.
 Results and discussion. In two of the patients, the cause of RFB was sexual abuse, and in the third, violent acts. Removed objects: dildo, metal deodorant bottle and glass beaker. RFB in all individuals was diagnosed with a finger rectal examination. In one patient with RFB was removed under local anesthesia, and in two patients used general anesthesia with muscle relaxants. In one case, an attempt to remove RFB was successful, in the other, a laparotomy, colotomy, and preventive sigmostomy were required.
 Conclusions. Patients with RFB need differentiated therapeutic tactics. In most patients, it is possible to remove it in a conservative way, peranally, using local anesthesia or endotracheal narcosis with muscle relaxants. For large, tightly clamped objects that cannot be removed conservatively indicated open laparotomy, colotomy.