Foreign Body (Bottle) in Rectum

Abstract

The following case is considered of sufficient interest to merit addition to the increasing list of medical curiosities. The unusual nature of the foreign body stimulated our interest in searching the literature for similar oddities. The reader is referred to the appended bibliography for equally interesting cases. C. K., a white American sailor, aged 31, entered the accident ward, Jan. 24, 1943, complaining of pain in the lower abdomen, inability to have a bowel movement, and bleeding from the bowel on attempting defecation. On the preceding day he had drunk himself into an alcoholic coma and remembered no more until the morning of admission. At that time he made several attempts to satisfy an overwhelming desire to defecate but was unsuccessful. On “bearing down” he observed a trickle of blood from his rectum. Through self examination he felt a hard object inside the anal orifice. Through a rectal speculum the bottom of a bottle was seen approximately 3 cm. from the anal orifice. The abdomen was tender. Pain was aggravated by deep breathing, coughing, and sneezing. Roentgenographic examination showed the bottle to be in the sigmoid and iliac colon with its open end pointing upwards. Calculi were also noted in the gallbladder area. Under spinal anesthesia the bottle was extracted manually by Dr. J. Surver of the Department of Surgery. The anus was dilated and all of the fingers of one hand could be placed inside of the rectum to grasp the bottle and effect its removal. Following the “delivery” the abdomen remained tender for three days but there was no elevation of temperature or pulse rate. In a week all symptoms subsided and the patient was discharged. A review of the literature on foreign bodies in the rectum shows this to be the eighth recorded case in which a bottle was present (1, 2, 3, 4, 19). The most remarkable among the foreign bodies reported in the literature up to the present date are: a snuff-box (1); whiskey glasses (1, 5, 6, 7, 17, 18); a 30-cm. mortar pestle (1); ox horns (1, 8); electric light bulbs (9, 10); an ink bottle (11); a vaseline bottle (12); a cold cream jar and lemon (13); an apple (14); chicken bones (15); glass tube (16); portion of a broom handle (17); frozen pig's tail (1); tool box containing a piece of gun barrel, a screw driver, two hacksaws, a boring syringe, a file, several coins, thread and tallow (1). The tool box and its contents were removed from a prisoner who made his escape through death from obstipation. At autopsy the tool kit was found to have migrated into the transverse colon. Some of the methods of extracting these foreign bodies have been most ingenious. In the case of the pig's tail, held in the anus of a French prostitute by shortly cropped bristles, the passage of a lubricated hollow willow, into the anus around the foreign body, with subsequent removal of both willow and tail, speaks well for the ingenuity of 16th-century surgeons.