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Zhou PF, Lu JG, Zhang JD, Wang JW. Colonoscopy-assisted removal of an impaction foreign body at the rectosigmoid junction: A case report. World J Clin Cases 2024; 12:1990-1995. [PMID: 38660553 PMCID: PMC11036519 DOI: 10.12998/wjcc.v12.i11.1990] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 02/07/2024] [Accepted: 03/15/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND When an anorectal foreign body is found, its composition and shape should be evaluated, and a timely and effective treatment plan should be developed based on the patient's symptoms to avoid serious complications such as intestinal perforation caused by displacement of the foreign body. CASE SUMMARY A 54-year-old male was admitted to our outpatient clinic on June 3, 2023, due to a rectal foreign body that had been embedded for more than 24 h. The patient reported using a glass electrode tube to assist in the recovery of prolapsed hemorrhoids, however, the electrode tube was inadvertently inserted into the anus and could not be removed by the patient. During hospitalization, the patient underwent surgery, and the foreign body was dragged into the rectum with the aid of colonoscopy. The anus was dilated with a comb-type pulling hook and an anal fistula pulling hook to widen the anus and remove the foreign body, and the local anal symptoms were then relieved with topical drugs. The patient was allowed to eat and drink, and an entire abdominal Computed tomography (CT) and colonoscopy were reviewed 3 d after surgery. CT revealed no foreign body residue and colonoscopy showed no metal or other residues in the colon and rectum, and no apparent intestinal tract damage. CONCLUSION The timeliness and rationality of the surgical and therapeutic options for this patient were based on a literature review of the clinical signs and conceivable conditions in such cases. The type, material and the potential risks of rectal foreign bodies should be considered.
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Affiliation(s)
- Peng-Fei Zhou
- Department of Anorectal Surgery, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai 200000, China
| | - Jin-Gen Lu
- Department of Anorectal Surgery, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai 200000, China
| | - Jia-Dong Zhang
- Department of Anorectal Surgery, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai 200000, China
| | - Jia-Wen Wang
- Department of Anorectal Surgery, Longhua Hospital Shanghai University of Traditional Chinese Medicine, Shanghai 200000, China
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Gupta RK, Kumar A, Khanal B, Suraj KC, Lamichhane S. Cough syrup bottle at rectum in elderly male: a rare case report. J Surg Case Rep 2023; 2023:rjad404. [PMID: 37434718 PMCID: PMC10331801 DOI: 10.1093/jscr/rjad404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Accepted: 06/17/2023] [Indexed: 07/13/2023] Open
Abstract
Foreign body in the anal canal may be inserted for sexual gratification or sexual assault or accidental or drug trafficking. We report a case of a male who accidentally inserted a cough syrup bottle in his rectum. Presentation is usually late due to fear and embarrassment. The manual attempt of removal may be tried under adequate anesthesia. Post-procedure sigmoidoscopy or colonoscopy may be helpful to diagnose laceration or mucosal injury.
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Affiliation(s)
- Rakesh K Gupta
- Department of General Surgery, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Abhijeet Kumar
- Department of General Surgery, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Bhawani Khanal
- Department of General Surgery, BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - K C Suraj
- Correspondence address. Department of General surgery, BP Koirala Institute of Health Sciences, Buddha Road, Dharan 56700, Nepal. Tel: +9779841622404; E-mail:
| | - Samiksha Lamichhane
- Department of Radiodiagnosis and Imaging, BP Koirala Institute of Health Sciences, Dharan, Nepal
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Yang Z, Xin P, Zhou S, Zhou C, He X, Bao G. Systematic review of rectal foreign bodies in older men: humanistic care and a novel challenge for society. ANNALS OF TRANSLATIONAL MEDICINE 2022; 10:164. [PMID: 35280427 PMCID: PMC8908176 DOI: 10.21037/atm-22-103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Accepted: 02/16/2022] [Indexed: 11/16/2022]
Abstract
Background In recent years, rectal foreign bodies have become a common proctological emergency in the male population, especially older Chinese men, often requiring surgical intervention due to associated complications. This review aimed to describe the epidemiology and clinical characteristics of rectal foreign bodies in older men and examine the possible challenges presented by the condition to clinicians and society. Methods A comprehensive search was conducted in English-language databases and Chinese databases from January 2000 to December 2020. Studies concerning rectal foreign bodies were considered for this review if they reported the reason for a foreign body being in the rectum and related treatment measures. Contemporaneous rectal foreign bodies case data from General Surgery Department of Tangdu Hospital were also analyzed. According to differences in ethnicity, the older male patients were divided into a Chinese group and a non-Chinese group, and the parameters of the two groups were analyzed using statistical methods. Results A total of 159 studies were retrieved in an initial database search using “rectal foreign body” as the search term. These included 86 Chinese studies and 73 English-language studies. Collectively, these studies included 582 older male patients, 276 of whom were Chinese, and 307 who were non-Chinese. According to their source, the rectal foreign bodies were classified into 3 categories. The most common reason for a foreign body in the rectum was insertion for erotic purposes, with everyday articles accounting for most foreign body types. Sexual articles were mainly found to have been used in the pursuit of pleasure. There were no significant differences in foreign body sources, sizes, types, treatment selections, and outcomes between the two groups. Discussion Emergency hospital visits by older men with rectal foreign bodies due to erotic and sexual needs and practices are increasing. Although the sources, sizes, and types of foreign bodies were different, and patients recovered well after active and appropriate clinical treatment, the sexual needs of older men are a social issue that requires attention. Acknowledging and dealing with sexual issues is a multidimensional task that requires a collaborative effort to ensure a more humanistic approach to older patients.
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Affiliation(s)
- Zhenyu Yang
- Department of General Surgery, Tangdu Hospital, Air Force Medical University, Xi'an, China
| | - Peiyuan Xin
- Department of General Surgery, Tangdu Hospital, Air Force Medical University, Xi'an, China
| | - Shuai Zhou
- Department of General Surgery, Tangdu Hospital, Air Force Medical University, Xi'an, China
| | - Chuxin Zhou
- Department of General Surgery, Tangdu Hospital, Air Force Medical University, Xi'an, China
| | - Xianli He
- Department of General Surgery, Tangdu Hospital, Air Force Medical University, Xi'an, China
| | - Guoqiang Bao
- Department of General Surgery, Tangdu Hospital, Air Force Medical University, Xi'an, China
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Kumar P, Rehman S, Rana AKS. Approach to rectal foreign body: an unusual presentation. BMJ Case Rep 2018; 2018:bcr-2018-224253. [PMID: 29804075 DOI: 10.1136/bcr-2018-224253] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
Foreign bodies in the rectum are commonly confronted worldwide in the surgical emergency. Such a situation arises either accidentally or for autoerotic purposes. A wide variety of foreign objects have been reported in the literature and this usual object would add to the reports for its unusual location. We report a case of a 26-year-old young man with accidental insertion of hand shower in the rectum and no signs of any active bleed or peritonism. Extraction was done successfully in the operating room under general anaesthesia, with an uneventful postprocedure period and the patient was discharged after 48 hours of observation. Rectal foreign bodies can be of wide variety and can lead to life-threatening conditions. An orderly approach is required for diagnosis, management and evaluation in the postprocedure period.
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Affiliation(s)
- Peeyush Kumar
- Department of Surgery, Dr Ram Manohar Lohia Hospital and Post Graduate Institute of Medical Education and Research, New Delhi, India
| | - Samar Rehman
- Department of Surgery, Dr Ram Manohar Lohia Hospital and Post Graduate Institute of Medical Education and Research, New Delhi, India
| | - Anil Kumar Singh Rana
- Department of Surgery, Dr Ram Manohar Lohia Hospital and Post Graduate Institute of Medical Education and Research, New Delhi, India
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5
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A novel technique for minimally invasive removal of a foreign body in the rectal wall. Tech Coloproctol 2018; 22:313-317. [DOI: 10.1007/s10151-018-1780-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 12/03/2017] [Indexed: 10/17/2022]
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Foreign bodies in the rectum: 2 Case reports. North Clin Istanb 2017; 4:93-96. [PMID: 28752152 PMCID: PMC5530167 DOI: 10.14744/nci.2015.30592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2015] [Accepted: 08/07/2015] [Indexed: 11/20/2022] Open
Abstract
Encountering a foreign object in the rectum is rare; however, the incidence has greatly increased in recent years. Treatment of these patients requires a multidisciplinary approach because this condition may have serious complications. Presently described is management of 2 cases of rectal foreign body treated in the clinic.
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Abstract
Foreign body (FB) within the rectum occurs infrequently and its management is challenging for the emergency physicians due to variation in type of objects, host anatomy, time of insertion, and amount of local contamination. Usually, the presentation is late after multiple unsuccessful attempts for the removal of the FB by patients themselves at home. We report a 50-year-old male patient presented to the emergency department with an FB in the rectum (iron rod) introduced as sexual perversion. The patient was managed conservatively and transanal retrieval of FB was carried out successfully. We reviewed the management options from the currently available literature.
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Affiliation(s)
| | - Pradip B Gupta
- Department of Emergency Medicine, Government Medical College, Surat, Gujarat, India
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Saturnino PP, Pinto A, Liguori C, Ponticiello G, Romano L. Role of Multidetector Computed Tomography in the Diagnosis of Colorectal Perforations. Semin Ultrasound CT MR 2015; 37:49-53. [PMID: 26827738 DOI: 10.1053/j.sult.2015.10.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Colonic perforations can be classified into perforations that occur at the site of a localized pathologic process and cecal perforations that occur secondary to distal colonic obstructions. Rectal perforations may result from foreign bodies inserted into the rectum; moreover, deep rectal biopsies, polypectomy, improper cleansing enema, or thermometer placement may also lead to rectal perforation. Correct identification of the cause and site of the perforation is crucial for appropriate management and surgical planning. Multidetector row computed tomography has a pivot role in planning the type of operative treatment, the prognosis, and in assessing those patients who have clinical symptoms of peritonitis but no radiographic signs of perforation.
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Affiliation(s)
| | - Antonio Pinto
- Department of Radiology, Cardarelli Hospital, Naples, Italy
| | - Carlo Liguori
- Department of Radiology, Cardarelli Hospital, Naples, Italy
| | | | - Luigia Romano
- Department of Radiology, Cardarelli Hospital, Naples, Italy
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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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10
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Elias B, Debs T, Hage S, Bassile B, Hanna P, Saint Eve P. Single incision laparoscopic surgery technique for transanal removal of rectal foreign body. J Surg Case Rep 2014; 2014:rju022. [PMID: 24876403 PMCID: PMC4197915 DOI: 10.1093/jscr/rju022] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Accepted: 02/28/2014] [Indexed: 11/12/2022] Open
Abstract
A foreign body in the rectum is not a very common surgical emergency case. In the treatment of rectal foreign bodies, the aim is to use the simplest possible method while protecting the integrity of the intestine. Many removal techniques have been described in the literature. Here we report a case in which a transanal technique using a single incision laparoscopic surgery port was successfully used.
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Affiliation(s)
- Bachir Elias
- General Surgery Department, CHR Metz-Thionville, Bel-Air Hospital, Thionville, France
| | - Tarek Debs
- General Surgery Department, CHR Metz-Thionville, Bel-Air Hospital, Thionville, France
| | - Said Hage
- General Surgery Department, CHR Metz-Thionville, Bel-Air Hospital, Thionville, France
| | - Bashir Bassile
- General Surgery Department, CHR Metz-Thionville, Bel-Air Hospital, Thionville, France
| | - Philippe Hanna
- General Surgery Department, CHR Metz-Thionville, Bel-Air Hospital, Thionville, France
| | - Patrick Saint Eve
- General Surgery Department, CHR Metz-Thionville, Bel-Air Hospital, Thionville, France
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Abstract
Rectal trauma is associated with high rates of morbidity and mortality and generally affects young males due to its aetiology of violent crime and vehicular collision. Historically, management has followed principles derived from military practice, with faecal diversion, pre-sacral drainage and distal washout being mandatory. Civilian trauma studies examining management of colon and rectum injuries from the early 1950s identified major differences in the level of energy transfer between civilian and military wounds, given that the vast majority are penetrating in nature. This led to a re-evaluation of the necessity for these interventions for all rectal injuries. Current management depends on whether the injury is intra- or extraperitoneal, with those above the peritoneal reflection being readily accessible and amenable to treatment as for colon injury. Extraperitoneal injuries remain difficult to access and direct repair is usually impossible; the mainstay of treatment in most instances remains faecal diversion. The role of pre-sacral drainage and distal washout remains contentious in the realms of civilian rectal injury but retains a place in battlefield or other high-energy transfer rectal injuries where aggressive early management reduces septic complications. This article reviews the historical and current evidence for the management of both civilian and military extraperitoneal rectal injuries.
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Affiliation(s)
- Sarah Barkley
- Department of Colorectal Surgery, Northern General Hospital, Sheffield, UK
| | - Mansoor Khan
- Department of General Surgery, Doncaster Royal Infirmary, Doncaster, UK
| | - Jeff Garner
- Rotherham NHS Foundation Trust and Academic Department of Military Surgery and Trauma, Royal Centre for Defence Medicine, Birmingham, UK
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