Foreign body in rectum- aerosol can

Abstract

A 53 year-old male with a history of schizophrenia and bipolar disorder presented to the emergency department with worsening abdominal pain. He reported inserting an aerosol can in his anus and was unable to remove the object. The can had been present since midnight the night before. He was concerned that the cap of the can had come loose when he was trying to remove the can from his rectum. On physical exam, his abdomen was distended with a palpable ventral hernia and foreign body. He reported minimal abdominal tenderness with palpation. Abdominal imaging (Figures 1 and 2) demonstrated a large metallic foreign object in the shape of a can in the sigmoid colon with extensive foci of free intraperitoneal air suggestive of bowel perforation. He was immediately taken to the operating room for surgical removal of foreign body. He underwent diagnostic laparoscopy with removal of rectal foreign body, peritoneal lavage, and closure of rectosigmoid perforation. The adhesiolysis portion of the surgical procedure had to be completed using the EndoShears to perform sharp cold adhesiolysis given the aerosol and concern for an intraoperative fire with use of any type of energy or cautery device.