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Kim H, Choi S, Yun J. Colorectal Foreign Bodies: Six Cases Report and Review of the Literature. JOURNAL OF TRAUMA AND INJURY 2015. [DOI: 10.20408/jti.2015.28.1.51] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Hyoungran Kim
- Trauma Center, Departments of General Surgery, Dankook University Hospital, Cheonan, Korea
| | - Seokho Choi
- Trauma Center, Departments of General Surgery, Dankook University Hospital, Cheonan, Korea
| | - Jeongseok Yun
- Trauma Center, Departments of General Surgery, Dankook University Hospital, Cheonan, Korea
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Pinto A, Miele V, Pinto F, Mizio VD, Panico MR, Muzj C, Romano L. Rectal Foreign Bodies: Imaging Assessment and Medicolegal Aspects. Semin Ultrasound CT MR 2015; 36:88-93. [DOI: 10.1053/j.sult.2014.11.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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53
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Sun HJ, Lee J, Kim DM, Chu MS, Park KS, Choi DJ. Rectal perforation caused by a sharp pig backbone in a middle-aged patient with mild depression. Yeungnam Univ J Med 2015. [DOI: 10.12701/yujm.2015.32.1.31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Hyeong Ju Sun
- Department of Internal Medicine, Daejeon Sun Hospital, Daejeon, Korea
| | - Jeonghun Lee
- Department of Internal Medicine, Daejeon Sun Hospital, Daejeon, Korea
| | - Dong Min Kim
- Department of Internal Medicine, Daejeon Sun Hospital, Daejeon, Korea
| | - Myeong-Su Chu
- Department of Internal Medicine, Daejeon Sun Hospital, Daejeon, Korea
| | - Kyoung Sun Park
- Department of Internal Medicine, Daejeon Sun Hospital, Daejeon, Korea
| | - Dong Jin Choi
- Department of General Surgery, Daejeon Sun Hospital, Daejeon, Korea
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54
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Aras A, Karabulut M, Kones O, Temizgonul KB, Alis H. A new and simple extraction technique for rectal foreign bodies: removing by cutting into small pieces. SURGICAL TECHNIQUES DEVELOPMENT 2014. [DOI: 10.4081/std.2014.5538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
The purposes of insertion and types of foreign bodies in rectum show great variation. Rectal foreign bodies need to be removed without giving damage to intestinal wall and this should be done in the easiest possible way. We have reported a new and a simple technique. It is easy to apply and safe. A patient was admitted to our clinic with a rectal foreign body (radish) which was successfully removed by cutting it into small pieces. We conclude that different kinds of rectal foreign bodies, especially fruit and vegetables, can be removed by this technique.
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55
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Wong JCT, Yau AHL, Ko HH. Unusual rectal foreign body for drug screen evasion. BMJ Case Rep 2014; 2014:bcr-2014-207897. [DOI: 10.1136/bcr-2014-207897] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Ozbilgin M, Arslan B, Yakut MC, Aksoy SO, Terzi MC. Five years with a rectal foreign body: A case report. Int J Surg Case Rep 2014; 6C:210-3. [PMID: 25553525 PMCID: PMC4334645 DOI: 10.1016/j.ijscr.2014.11.053] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Revised: 10/30/2014] [Accepted: 11/08/2014] [Indexed: 01/10/2023] Open
Abstract
INTRODUCTION Rectal foreign bodies are rare colorectal emergencies. They are important for the complications that may occur. Delayed response causes a wide range of complications or may even result in death. PRESENTATION OF CASE A 22 years old male patient was seen at our hospital with anal pain, discharge, and complaining of incontinence. The patient stated that a bottle of beverage was placed into his anal canal in an inverted manner for sexual satisfaction 5 years previously. DISCUSSION After clinical and radiological assessment under general anaesthesia in the lithotomy position the object was removed by a laparotomy. He was advised to seek legal help and he received psychiatric treatment in the postoperative period prior to his discharge. CONCLUSION Complications such as abscess, perianal fistula complicated by severe pelvic sepsis and osteomyelitis were expected complications in this case. As in this case, a surgical approach may eliminate dissection planes, increasing morbidity and mortality related to the injuring of surrounding bodies during object extraction.
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Affiliation(s)
- Mücahit Ozbilgin
- Dokuz Eylül University Faculty of Medicine, Department of General Surgery, İzmir, Turkey.
| | - Baha Arslan
- Kemalpasa State Hospital, General Surgery, Izmir, Turkey.
| | - Mehmet Can Yakut
- Bornova Türkan Özilhan State Hospital, General Surgery, Izmir, Turkey.
| | - Süleyman Ozkan Aksoy
- Tepecik Training and Research Hospital, 2nd General Surgery Department, Izmir, Turkey.
| | - Mustafa Cem Terzi
- Dokuz Eylül University Faculty of Medicine, Department of General Surgery, İzmir, Turkey.
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Abstract
Rectal foreign bodies represent a challenging and unique field of colorectal trauma. The approach includes a careful history and physical examination, a high index of suspicion for any evidence of perforation, a creative approach to nonoperative removal, and appropriate short-term follow-up to detect any delayed perforation.
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Affiliation(s)
- Kyle G Cologne
- Division of Colon and Rectal Surgery, Department of Surgery, The University of Southern California, Los Angeles, California
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58
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Olaoye IO, Adensina MD. Retained rectal foreign body with rectal perforation; a complication of the traditional management of haemorrhoids: a case report. Trop Doct 2013; 43:158-60. [PMID: 24065516 DOI: 10.1177/0049475513505088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Retained rectal foreign bodies are most commonly seen in homosexuals and after assault. A few have been reported after self-treatment of anorectal conditions and prostatic massage. Harmful traditional medical practices have been reported in many communities in Africa but therapeutic anal insertion of foreign bodies for the management of haemorrhoids is rare. We present a patient with features of peritonitis following insertion of a wine bottle into his rectum in an attempt to manage his prolapsed haemorrhoids.
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Abstract
A SILS port may allow minimally invasive extraction of a rectal foreign body not amenable to simple manual extraction. Introduction: The impacted rectal foreign body often poses a management challenge. Ideally, such objects are removed in the emergency department utilizing a combination of local anesthesia, sedation, minimal instrumentation, and manual extraction. In some instances, simple manual extraction is unsuccessful and general anesthesia may be necessary. We describe a novel approach to retrieval and removal of a rectal foreign body utilizing a SILS port. Case Description: A 31-y-old male presented to the emergency department approximately 12 h after transanal insertion of a plastic cigar case. Abdominal examination revealed no evidence of peritonitis. On rectal examination, the tip of the cigar case was palpable. The foreign body, however, was unable to be removed manually in the emergency department. In the operating room, with the patient under general anesthesia, multiple attempts to remove the object were unsuccessful. A SILS port was inserted transanally. The rectum was then insufflated manually by attaching the diaphragm of the rigid sigmoidoscope to the SILS insufflation port. A 5-mm 0-degree laparoscope was placed through the SILS port. An atraumatic laparoscopic grasper was then placed through the port and used to grasp the visible end of the cigar case. The rectal foreign body was removed expeditiously. Direct visualization of the rectum revealed no evidence of mucosal injury. The patient was discharged home shortly after the procedure. Discussion: The SILS port allows minimally invasive extraction of rectal foreign bodies not amenable to simple manual extraction. It provides excellent visualization and eliminates the morbidity inherent in more invasive and traditional methods of retrieval.
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Affiliation(s)
- Yury Bak
- Department of Surgery, University of Medicine and Dentistry of New Jersey, Stratford, NJ, USA
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Affiliation(s)
- Arshad Rashid
- Dr. Arshad Rashid, Department of Surgery,, Government Medical College,, Srinagar, Karan Nagar Srinagar 190010,, India, T: +917838194782, F: +918059931539,
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Coskun A, Erkan N, Yakan S, Yıldirim M, Cengiz F. Management of rectal foreign bodies. World J Emerg Surg 2013; 8:11. [PMID: 23497492 PMCID: PMC3601006 DOI: 10.1186/1749-7922-8-11] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2013] [Accepted: 03/08/2013] [Indexed: 01/05/2023] Open
Abstract
Background Entrapped anorectal foreign bodies are being encountered more frequently in clinical practice. Although entrapped foreign bodies are most often related to sexual behavior, they can also result from ingestion or sexual assault. Methods Between 1999 and 2009, 15 patients with foreign bodies in the rectum were diagnosed and treated, at Izmir Training and Research Hospital, in Izmir. Information regarding the foreign body, clinical presentation, treatment strategies, and outcomes were documented. We retrospectively reviewed the medical records of these unusual patients. Results All patients were males, and their mean age was 48 years (range, 33–68 years). The objects in the rectum of these 15 patients were an impulse body spray can (4 patients), a bottle (4 patients), a dildo (2 patient), an eggplant (1 patient), a brush (1 patient), a tea glass (1 patient), a ball point pen (1 patient) and a wishbone (1 patient, after oral ingestion). Twelve objects were removed transanally by anal dilatation under general anesthesia. Three patients required laparotomy. Routine rectosigmoidoscopic examination was performed after removal. One patient had perforation of the rectosigmoid and 4 had lacerations of the mucosa. None of the patients died. Conclusions Foreign bodies in the rectum should be managed in a well-organized manner. The diagnosis is confirmed by plain abdominal radiographs and rectal examination. Manual extraction without anaesthesia is only possible for very low-lying objects. Patients with high- lying foreign bodies generally require general anaesthesia to achieve complete relaxation of the anal sphincters to facilitate extraction. Open surgery should be reserved only for patients with perforation, peritonitis, or impaction of the foreign body.
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Affiliation(s)
- Ali Coskun
- Izmir Training and Research Hospital, Department of Surgery, Mithatpasa Cad, 964, Goztepe-Izmir, Turkey.
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Anorectal Injuries due to Foreign Bodies: Case Reports and Review of the Management Options. Case Rep Surg 2013; 2013:809592. [PMID: 23533918 PMCID: PMC3603618 DOI: 10.1155/2013/809592] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2013] [Accepted: 02/13/2013] [Indexed: 11/17/2022] Open
Abstract
Anorectal injuries due to autoerotic activity with rectal foreign bodies were identified in four male patients. The objects were bottle in one patient, glasses in two patients, and showerhead in one patient. Foreign bodies were extracted within lithotomy position after anal dilatation, under general anesthesia in 3 patients. One patient presented with peritoneal irritation and had a diagnosis of rectal perforation. He underwent transanal rectal repair with proximal fecal diversion. In this paper we described 4 patients who had anorectal injuries due to autoerotic activity with foreign bodies and reviewed the management options in literature.
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64
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Abate G, Shirin M, Kandanati V. Fournier gangrene from a thirty-two-centimeter rectosigmoid foreign body. J Emerg Med 2012. [PMID: 23200766 DOI: 10.1016/j.jemermed.2012.09.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
BACKGROUND Medical and surgical problems associated with rectal foreign bodies are rare. Although most rectal foreign bodies can be removed without subsequent sequelae, they pose significant risk of infection. OBJECTIVES We report a patient with a 32-cm rectosigmoid foreign body and subsequent development of Fournier gangrene despite successful removal of the foreign body. CASE REPORT A 63-year-old Caucasian man with past medical history of diabetes mellitus and depression presented with a chief complaint of "something stuck in my intestine." He admitted that he placed a foreign body in the rectum. Abdominal X-ray study and computed tomography of the abdomen/pelvis showed a conical-shaped 32-cm rectosigmoid foreign body. The foreign body was removed manually and follow-up colonoscopy was done. The patient's condition deteriorated in the first 2 days of hospital stay and he was diagnosed with Fournier gangrene. He required multiple surgeries and received broad-spectrum antibiotic coverage for mixed bacterial flora grown from deep tissue. CONCLUSION Rectal foreign bodies can cause Fournier gangrene. A close observation and follow-up is important after removal of rectal foreign bodies.
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Affiliation(s)
- Getahun Abate
- Division of Infectious Diseases, Department of Internal Medicine, Saint Louis University, St. Louis, MO 63104, USA
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65
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Ayantunde AA. Approach to the diagnosis and management of retained rectal foreign bodies: clinical update. Tech Coloproctol 2012; 17:13-20. [PMID: 22993140 DOI: 10.1007/s10151-012-0899-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2012] [Accepted: 09/06/2012] [Indexed: 12/14/2022]
Abstract
Retained rectal foreign body is not an uncommon condition, but reliable epidemiological data are not available. The diagnosis and management can present a significant challenge due to delayed presentation and the reluctance of the patients to provide details of the incident. The aim of the clinical evaluation is to identify the type, number, size, shape and location of the foreign body. Removal of retained rectal foreign bodies requires experience, with particular attention to different methods of extracting various objects. Most retained rectal foreign bodies can be successfully extracted transanally under appropriate anaesthesia and only a small proportion, mostly cases of perforation, overt peritonitis, pelvic sepsis or for failure of transanal extraction, will require open surgery or laparoscopy. It is mandatory to perform a proctosigmoidoscopy after anorectal foreign body removal to exclude bowel injury and ensure that the patient has not inserted more than one foreign body. Patients with mucosal abrasion, tears and oedema are to be admitted for a period of observation.
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Affiliation(s)
- A A Ayantunde
- Department of Surgery, Colorectal Unit, Southend University Hospital, Prittlewell Chase, Westcliff-on-Sea, Essex, SS0 0RY, UK.
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66
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Vaquero LM, García M, Álvarez B, Pisabarros C, Sierra M, Diez R, Vivas S. [Terminal ileitis of uncommon etiology]. GASTROENTEROLOGIA Y HEPATOLOGIA 2012; 35:608-9. [PMID: 22398378 DOI: 10.1016/j.gastrohep.2012.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2011] [Accepted: 01/08/2012] [Indexed: 11/18/2022]
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Kasotakis G, Roediger L, Mittal S. Rectal foreign bodies: A case report and review of the literature. Int J Surg Case Rep 2011; 3:111-5. [PMID: 22288061 DOI: 10.1016/j.ijscr.2011.11.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2011] [Revised: 11/26/2011] [Accepted: 11/28/2011] [Indexed: 10/14/2022] Open
Abstract
INTRODUCTION Rectal foreign bodies (RFB) present the modern surgeon with a difficult management dilemma, as the type of object, host anatomy, time from insertion, associated injuries and amount of local contamination may vary widely. Reluctance to seek medical help and to provide details about the incident often makes diagnosis difficult. Management of these patients may be challenging, as presentation is usually delayed after multiple attempts at removal by the patients themselves have proven unsuccessful. PRESENTATION OF CASE In this article we report the case of a male who presented with a large ovoid rectal object wedged into his pelvis. As we were unable to extract the object with routine transanal and laparotomy approach, we performed a pubic symphysiotomy that helped widen the pelvic inlet and allow transanal extraction. DISCUSSION We review currently available literature on RFB and propose an evaluation and management algorithm of patients that present with RFB. CONCLUSION Management of patients with rectal foreign bodies can be challenging and a systematic approach should be employed. The majority of cases can be successfully managed conservatively, but occasional surgical intervention is warranted. If large objects, tightly wedged in the pelvis cannot be removed with laparotomy, pubic symphysiotomy should be considered.
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Affiliation(s)
- G Kasotakis
- Department of Surgery, Division of Trauma, Emergency Surgery & Surgical Critical Care, Massachusetts General Hospital, Boston, MA, United States
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68
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Desai B. Visual diagnosis: Rectal foreign body: A primer for emergency physicians. Int J Emerg Med 2011; 4:73. [PMID: 22152071 PMCID: PMC3253678 DOI: 10.1186/1865-1380-4-73] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2011] [Accepted: 12/07/2011] [Indexed: 11/20/2022] Open
Abstract
We present a case that is occasionally seen within emergency departments, namely a rectal foreign body. After presentation of the case, a discussion concerning this entity is given, with practical information on necessity of an accurate and thorough history and removal of the object for clinicians.
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Affiliation(s)
- Bobby Desai
- Department of Emergency Medicine, University of Florida, PO Box 100186, Gainesville 32610, FL, USA.
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69
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Fisher DA, Maple JT, Ben-Menachem T, Cash BD, Decker GA, Early DS, Evans JA, Fanelli RD, Fukami N, Hwang JH, Jain R, Jue TL, Khan KM, Malpas PM, Sharaf RN, Shergill AK, Dominitz JA. Complications of colonoscopy. Gastrointest Endosc 2011; 74:745-52. [PMID: 21951473 DOI: 10.1016/j.gie.2011.07.025] [Citation(s) in RCA: 234] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2011] [Accepted: 07/15/2011] [Indexed: 12/17/2022]
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70
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Anderson KL, Dean AJ. Foreign Bodies in the Gastrointestinal Tract and Anorectal Emergencies. Emerg Med Clin North Am 2011; 29:369-400, ix. [DOI: 10.1016/j.emc.2011.01.009] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Giorgini E, Di Saverio S, Biscardi A, Villani S, Clemente N, Antonacci N, Tugnoli G. Pandora's box: a threatening foreign body. BMJ Case Rep 2011; 2011:2011/apr15_1/bcr0620103110. [PMID: 22701029 DOI: 10.1136/bcr.06.2010.3110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Affiliation(s)
- Eleonora Giorgini
- Emergency and Trauma Surgery Unit, Maggiore Hospital Trauma Center, Bologna, Italy
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72
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Abstract
Foreign digestive bodies present unusual circumstances because they are associated with various degrees of local trauma and may lead to direct perforation or delayed local injury. Patients with foreign bodies should be evaluated upon admission for signs of impaction and perforation. While all objects impacted in the esophagus require urgent treatment, rectal foreign bodies are usually removable through the anus. The current case illustrates successful endoscopic retrieval of a proximally located foreign body in a particular legal situation where physicians had to work closely with police officers and court members.
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Affiliation(s)
- Jean Louis Frossard
- Department of Internal Medicine, Division of Gastroenterology, Hôpital Cantonal Universitaire de Genève, Geneva, Switzerland
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Jung EJ, Ryu CG, Kim G, Hwang DY. Impaction of a foreign body in the rectum by improper use of a (electronic) massager: a case report. JOURNAL OF THE KOREAN SOCIETY OF COLOPROCTOLOGY 2010; 26:298-301. [PMID: 21152233 PMCID: PMC2998008 DOI: 10.3393/jksc.2010.26.4.298] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/05/2010] [Accepted: 06/14/2010] [Indexed: 10/26/2022]
Abstract
A male, 67 years old, visited the emergency room because of a foreign body impacted in his rectum. While he was being treated for grade-II hemorrhoids conservatively, he heard that massage of the peri-anal area could be helpful for preventing hemorrhoids. Thus, while using an electronic massager after placing the head of the machine into a short round bar, the head became separated from the machine, and this was inserted into the anus and impacted. The patient had anal discomfort without abdominal pain. His vital signs were stable, and no abnormal physical findings were found for the abdomen. On digital rectal examination, the rim of the foreign body was palpated about 8 cm from the anal verge. Anal bleeding, abnormal discharge, or foul odor was not found. On a simple abdominal X-ray, a radio-opaque foreign body was observed in the pelvic cavity, and mild leukocytosis was noted on the laboratory test. To avoid injury to the anal sphincter, we tried to remove the foreign body under the spinal anesthesia. After anesthesia had been administered, the foreign body was palpated more distally at 5-6 cm from the anal verge by digital examination, and the foreign body was found to have a hole in its center. This was held using a Kelly clamp, and with digital guiding, was removed through the anus. After removal, an anoscopic examination was performed to determine if mucosal injury had occurred in the rectum or anal canal. The patient was discharged without complication after 24 hours of close observation.
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Affiliation(s)
- Eun-Joo Jung
- Colorectal Cancer Center, Department of Surgery, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea
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