Rectal Foreign Body Research Articles

An Unusual Case of Self-Inserted Rectal Foreign Body: Successful Management with Manual Extraction Under Spinal Anesthesia

Background: Rectal foreign bodies (RFBs) are an uncommon presentation to the emergency department (ED), often encountered by emergency medicine, surgery, and internal medicine specialists. Their management can be challenging, ranging from simple manual extraction to complex surgical interventions. Case presentation: A 19-year-old male presented to the ED with lower abdominal and anal pain. He admitted to self-inserting a plastic bottle into his rectum for autoerotic purposes. A physical examination revealed a palpable tubular mass in the rectosigmoid region, confirmed by a pelvic X-ray. The patient successfully underwent manual transanal extraction of the foreign body under spinal anesthesia, with no complications. Conclusion: This case highlights the importance of a thorough history and physical examination in patients presenting with RFBs. Prompt diagnosis and appropriate management, including manual extraction when feasible, can lead to successful outcomes.

S2805 Light at the End of the Tunnel: Successful Retrieval of a Large Rectal Foreign Body

S2805 Light at the End of the Tunnel: Successful Retrieval of a Large Rectal Foreign Body

Exploring Uncharted Waters: A Unique Case of Accidental Rectal penetration of Health Faucet

Rectal foreign bodies require careful diagnosis amid patient embarrassment. Timely assessment is crucial to manage complications. Removal methods vary, including trans-anal, endoscopic, or surgical approaches. Our case highlights successful trans-anal extraction of health faucet from rectum, emphasizing the need for sensitive and efficient management.

Better out than in: a case series of retained rectal foreign bodies in a New York Community Hospital

Better out than in: a case series of retained rectal foreign bodies in a New York Community Hospital

ENDOSCOPIC TRANSANAL REMOVAL OF EGG FROM RECTOSIGMOIDAL JUNCTION

It is not uncommon that we encounter patients with different kinds of foreign bodies in the rectumfor a variety of reasons. Most of the cases reported in the literature reveal that rectal foreign body insertion is mainly for sexual gratification. To avoid the embarrassment and scrutiny, patients often delay seeking medical help which complicatesmedical management. We discuss a case of a 21-year-old male who presented after voluntary insertion of multiple eggs into the anus. Although the suggested protocol and technique was followed to retrieve the egg and the debris, it still required some creativity and careful methodology.

Rectal Foreign Body in Male: A Case Report

The rectal foreign body is a rare presentation, often related to sexual gratification, sexual assault, or the result of ingestion and rarely accidental. The majority of rectal foreign bodies inserted by adults are for self-gratification. As a result, they will probably be smooth, rounded, tubular, or egg-shaped to make insertion and extraction easier. Herein, we describe a 55-year-old man with accidental insertion of a foreign body (tumbler made of steel ) through the anus 1 day prior without peritonitis into a region 4cm from the anal verge. It should be noted that early diagnosis and timely intervention are important to prevent complications in rectal foreign bodies. Assessment of the shape, size, nature, and location of the object through appropriate imaging is necessary. Exploratory laparotomy is inevitable in cases of failed manual extraction techniques and complicated cases.

A long rectal foreign body successfully removed after colonoscopy.

A man in his 70s, without prior foreign body history, presented to the emergency department 15 days after accidentally inserting a tubular object into his anus. He reported a reduction in normal bowel movements. Initial physical examination was normal. An abdominal X-ray revealed a tubular hypodensity in the pelvic region, without perforation. Subsequently, it was decided to perform a colonoscopy during which a foreign body was visualized in the distal rectum, that was successfully removed with the use of a rat tooth forceps. The foreign body was a plastic tube about 18cm in size. Afterwards, the rest of the colon was assessed, having identified an ulcer in the lower rectum related to the presence of the object. Six months later, the patient reported no complains and a follow-up colonoscopy was conducted which was normal. Discussion: Rectal foreign bodies, whose size and shape are variable and sometimes aberrant, are often self-inserted for self-gratification by adults, and its incidence is increasing. Patients typically avoid immediate medical attention and seek help only when complications arise. Formal clinical guidelines are lacking, and this case illustrates the importance of clinical judgement in the management of rectal foreign bodies, whether endoscopic or surgical.

Characteristics and Outcomes Associated With Emergent Rectal Foreign Body Management: A Retrospective Cohort Analysis.

Background Bedside management and outcomes of rectal foreign bodies remain challenging due to the presentation and complexity of the inserted objects. Injuries, such as perforation of the colon and rectum, are among the most commonly reported complications. However, prior studies are unclear regarding the setting in which the complication rates may be minimized. This study aimed to assess whether there was a statistically significant difference among the various extraction methods with regard to complications in the emergency department and operating room. Materials and methods This was a retrospective study of all cases of rectal foreign bodies that were removed in the emergency department at a large county hospital between 1/1/2010 and 12/31/2020. Patients included in this study were adults who were evaluated and treated in the emergency department. Results A total of 78 patients were included in the final analysis. More than half (51.3%, n=40) of the patients were successfully treated in the emergency department. Compared with the emergency department, patients in the operating room were more likely to undergo exploratory laparotomy and colectomy (0% vs. 31.6%, p<0.0001), undergo general anesthesia (84.2% vs. 0%, p<0.0001), have higher complication rates (21% vs. 0%, p=0.0021), and have a longer hospital length of stay (median=1 vs. 0, p<0.0001). Conclusion This study revealed a >50% success rate of rectal foreign body removal in the emergency departmentwithout any reported complications. To improve the success rate of bedside retrieval and decrease complications, physicians need to be vigilant, communicative, and compassionate about their evaluations and clinical methodology.

Foreign body in rectum- aerosol can

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.

Caring for a patient with a rectal foreign body.

Caring for a patient with a rectal foreign body.

Foreign Body in Rectum: A Rare Case Report

Rectal foreign body is a rare clinical entity. Approach includes a careful history and examination to rule out peritonitis and removal by conservative or operative approach. Most commonly bottles and glasses found. Other objects include toothbrushes, deodorant bottles, food articles, knives, cell phones, flash lights, ornaments, etc. Reasons for insertion include autoeroticism, concealment, attention seeking behaviour, accidental, assault and to alleviate constipation.&#x0D; Case Report: A 41 years old male came to emergency with complaint of pain per rectum from a bottle he had inserted in his rectum 10 hours prior to presentation. Multiple attempts to remove it at home failed. On examination abdomen was soft, non-tender, non-distended. An abdomen xray showed a large bottle shaped object in pelvis. The foreign body was palpable in the rectum but due to it’s shape, size and smooth surface it was impossible to retrieve it with simple manoeuvring even with simultaneous suprapubic pressure. All relevant investigations were done and patient was prepared for surgery. Exploratory laparotomy was done under spinal anaesthesia. Lower midline incision was given and bottle was pushed from above and taken out of anal canal. A glass bottle of size 11*5 cm was retrieved. Antibiotics and painkillers started. Patient recovered well and discharged on post op day 2.&#x0D; Conclusion: Management of patients with rectal foreign bodies can be challenging. Even though the majority of cases can be successfully managed conservatively, the operative techniques might also be needed.

Peculiar challenges of a glass object retained in rectum: review of current options

Rectal foreign bodies are rare and often challenging. It can vary from soft toys to hard glass or wooden objects. Patients are mostly habitual offenders who generally present to emergency due to retained foreign body or complications like perforation or bleeding. Proper history with a plain X-ray is often enough for the diagnosis and position of the foreign body. However, management can be varied from a simple trans-anal retrieval to an exploratory laparotomy. Minimal invasive techniques also have a role in current scenario. We report an unusual glass foreign body with its opening placed caudally.

Rectal Foreign Bodies: A 10-Year Review of the National Electronic Injury Surveillance System.

Introduction Rectal foreign bodies may result in significant morbidity, potentially necessitating surgical intervention and ostomy creation. The sensitive nature of the diagnosis may lead to inaccurate patient history and possible delay in diagnosis. Currently, there is a paucity of large national studies addressing this diagnosis. Therefore, we present national data describing the demographics and incidence of patients presenting with rectal foreign bodies. Methods The National Electronic Injury Surveillance System (NEISS) was utilized to collect data regarding rectal foreign bodies. Ten years of data were collected from 2012 to 2021. Inclusion criteria focused on the diagnosis of "foreign body" coupled with pelvic and lower torso injuries. Exclusion criteria encompassed patients without a rectal foreign body clearly identified in the narrative. Patients were compared based on disposition as low severity (treated/examined and released or left without being seen) or high severity (treated and admitted/hospitalized, held for observation, or transferred to another facility). General descriptive and inferential analyses were performed regarding demographics and dispositions. Results A total of 1,806 emergency department (ED) visits were identified for inclusion. Patients ranged in age from 0 to 93 years, with a mean age of 30 years. The largest age group identified was 11-15 and 21-25 years. Most patients were male (64.6%) and white (47.1%). The most common foreign bodies were massage devices and vibrators (22.7%), jewelry (8.1%), pens and pencils (4.4%), fishing gears (activity, apparel, or equipment) (3.7%), and nonglass bottles or jars (2.6%). Patients requiring admission, observation, or transfer differed from those patients that were discharged from the ED by age, sex, race, and product involved. Discussion Rectal foreign bodies are a rare diagnosis with a growing incidence. Though the most common objects are massage devices and vibrators consistent with sexual stimulation devices, there are limited product guidelines for safe use. Further studies to help identify at-risk persons, safety precautions, and manufacturing guidelines may help prevent potential morbidity associated with rectal foreign bodies.

Rectal Foreign Body Successfully Removed by Colonoscopic Snare Wire

Aim: The most common cause of rectal foreign bodies are objects used for sexual stimulation voluntarily by the patient. Different treatment methods are reported in the literature, and this article reports the transanal removal of the foreign body in the rectum with a snare wire without anesthesia, accompanied by colonoscopy. Case: An 80-year-old male patient was admitted to the emergency room because of the plastic rectal shower head that remained in the rectum and could not be removed while he was using a rectal douche for constipation. Contrast-enhanced abdominal computed tomograpyh (CT) showed a foreign body located in the rectosigmoid region without perforation findings. 12x1,5 cm tubular, well-circumscribed plastic foreign body embedded in the stool was removed with the help of colonoscopy in a controlled manner by holding it from its distal end with the help of endoscopic snare wire. Conclusion: Rectal foreign bodies can often be removed by the patient. However, in cases of foreign bodies in the rectum admitted to the hospital, the treatment method varies according to the type and location of the object, the occurrence of the event, and whether there are perforation findings in physical examination and imaging. Digital rectal examination is the critical first step in evaluating a patient with a rectal foreign body. Bedside extraction as the first-line treatment for low-lying anorectal foreign bodies without signs of perforation; endoscopic extraction is recommended as the first step in anorectal foreign bodies located high above the rectosigmoid junction. Because in cases without perforation, transanal removal of the foreign body is considered the first-line treatment and the success rate is approximately 75 %. The most essential condition for successful transanal removal of the foreign body in the rectum is the relaxation of the patient. Endoscopic examination is also recommended to evaluate the condition of the intestinal wall after the removal of the foreign body. In our case, we also removed the foreign body, which we found to be located in the middle rectum, in accordance with the literature, endoscopically.

A Case Report on Unsual Foreign Body in Rectum

We present a case report of unusual foreign body (FB) which was retrieved successfully with help of peglec (laxative,purgative). Our patient presented to ER with history of retained foreign body after self insertion for sexual pleasure Patient was then evaluated and foreign body retrieved.

Rectal Foreign Body Causing Perforation: A Case Report

The rectal foreign body is a rare presentation with rising incidence. We present a case of a 26-year-old heterosexual male with an alleged history of sexual assault with insertion of a large foreign body through the anus two days prior with peritonitis. After investigations, the patient underwent an exploratory laparotomy, foreign body removal, primary repair of perforation with a diverting colostomy. Diversion must be considered in cases where the extent of anal sphincter mechanism injury is in question. The patient had a good outcome. Assessment of the shape, size, nature, and location of the object through appropriate imaging is necessary. Exploratory laparotomy is inevitable in cases of perforation.

Epidemiology and healthcare utilization for rectal foreign bodies in United States adults, 2012–2021

IntroductionPresentations to the emergency department for rectal foreign bodies are common, but there is little epidemiologic information on this condition. This limits the ability to provide evidence-based education to trainees regarding the populations affected, the types and frequency of foreign bodies, and factors associated with hospitalization. To address this, we analyzed national estimates of emergency department presentations for rectal foreign bodies from 2012 to 2021 in the US. MethodsWe queried the National Electronic Injury Surveillance System for any injury to the ‘pubic region’ or ‘lower trunk’ with an accompanying diagnosis of foreign body, puncture, or laceration. Two authors manually reviewed all clinical narratives to identify cases of rectal foreign bodies. National estimates were determined using weighting and strata variables, incidence rates calculated using census data, trends assessed by linear regression, and factors associated with hospitalization identified by multivariable logistic regression. ResultsFrom 885 cases, there were an estimated 38,948 (95% CI, 32,040-45,856) emergency department visits for rectal foreign bodies among individuals ≥15 years from 2012 to 2021. The average age was 43, 77.8% were male, 55.4% of foreign bodies were sexual devices, and 40.8% required hospitalization. The annual incidence of presentations for rectal foreign bodies increased from 1.2 in 2012 to 1.9 per 100,000 persons in 2021 (R2 = 0.84, p < 0.01). Males have a bimodal age distribution peaking in the fifth decade, while females have a right-skewed age distribution peaking in the second decade. Female sex (odds ratio [OR] 0.4; 95% confidence interval [CI], 0.2–0.6) and, compared to sexual devices, balls/marbles (OR 0.2; 95% CI, 0.05–0.6) or drugs/paraphernalia (OR 0.1; 95% CI, 0.05–0.4) are associated with a reduced odds of hospitalization. ConclusionsPresentations to the emergency department for rectal foreign bodies increased for males and females from 2012 to 2021 in the United States. These epidemiologic estimates for a complex form of anorectal trauma provide preclinical information for emergency medicine, surgery, and radiology trainees.

An unusual rectal foreign body: A sundried corn-stick

Though common, the extraction of rectal foreign bodies is still a great challenge for surgeons. The foreign body's position can usually be verified by plain abdominal radiography. Given the potential of sexually transmitted disease, screening for HIV, hepatitis, and syphilis is warranted prior to intervention. The utilization and selection of surgical instruments need to be flexible, ingenious, and innovative.

Surgical management of rectal foreign bodies: A single-center experience.

Rectal foreign bodies (RFBs) are one of the rare clinical presentations in colorectal surgical practice, with an increasing incidence over the recent years. Due to the lack of standardized treatment options, the management of RFBs can be chal-lenging. This study aimed to evaluate our diagnostic and therapeutic approach to RFBs and to suggest a management algorithm. All patients with RFBs who hospitalized between January 2010 and December 2020 were retrospectively reviewed. Patient demographics, RFB insertion mechanism, inserted objects, diagnostic findings, management, complications, and outcomes were all evaluated. An algorithm for clinical management was developed depending on the center's experience. The cohort consisted of 21 patients, 17 (81%) were males. The median age was 33 years (ranging, 19-71). Sexual prefer-ences were the reason for RFB in 15 (71.4%) patients. In 17 (81%) patients, the RFB size over 10 cm. In 4 (19%) patients, RFBs were removed transanally without anesthesia in the emergency department; in the remaining 17 (81%), they were removed under anesthesia. Among these, RFBs were removed transanally under general anesthesia in 2 (9.5%) patients; with the assistance of a colonoscope under anesthesia in 8 (38%) patients; by milking towards the transanal route during laparotomy in 3 (14.2%) patients; and with the Hartmann procedure without restoration of bowel continuity in 4 (19%) patients. The median hospital stay was 6 days (ranging, 1-34 days). The Clavien-Dindo grade III-IV complication rate was 9.5%, and no post-operative mortality was observed. RFBs can usually be successfully removed transanally in the operating room with appropriate anesthetic technique and proper surgical instrument selection.

Unusual rectal foreign bodies: Case series and discussion

A series comprised of 04 patients is presented. The symptomatology, physical and x-ray findings are described. Methods of management are discussed, with emphasis on the operative management of perforations and the conservative approach to retained foreign bodies. It is felt that these protocols will be useful to physicians who see this practice less frequently. X-rays of two more unusual cases are depicted. A thorough review of the literature is also presented.