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Ghahremani GG, Naimi DR. Imaging of eggshells and eggs in the gastrointestinal tract: pictorial essay. Clin Imaging 2022; 91:64-68. [PMID: 36029664 DOI: 10.1016/j.clinimag.2022.08.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 08/15/2022] [Accepted: 08/19/2022] [Indexed: 11/30/2022]
Abstract
Ingestion of eggshell in its natural form or as ground and powdered product has become a popular means of dietary calcium supplementation in adults. These substances appear as conspicuous radiopaque material within the gastrointestinal tract on radiographs or computed tomography of the abdomen. The ingested eggshell fragments are usually visible as curvilinear structures on profile view, whereas the ground or powdered eggshells appear as granular densities. This article illustrates the spectrum of findings that are observed following eggshell ingestion by patients undergoing radiological evaluation for various unrelated medical conditions. Potential complications of eggshell consumption are discussed, and two cases of intra-rectal egg insertion for palliative relief of pelvic pain are presented.
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Affiliation(s)
- Gary G Ghahremani
- Department of Radiology, University of California-San Diego Medical Center, 200 West Arbor Drive, San Diego, CA 92103, USA.
| | - David R Naimi
- Department of Internal Medicine, US Naval Hospital Camp Pendleton, 200 Mercy Circle, Oceanside, CA 92055, USA
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2
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Management of unusual rectal foreign body - Case report and literature review. Int J Surg Case Rep 2022; 94:107051. [PMID: 35452941 PMCID: PMC9048151 DOI: 10.1016/j.ijscr.2022.107051] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 04/03/2022] [Accepted: 04/05/2022] [Indexed: 01/25/2023] Open
Abstract
Introduction Retained rectal objects represent a rare complaint in the emergency room, affecting mainly males between 20 and 40 years, with most objects of a sexual nature, but the examiner must be aware of objects of an unusual nature. Presentation of case A 54-year-old male patient arrives at the surgical emergency department, with a report of an accident with the insertion of an object via the rectum, a gym dumbbell. Initially opted for transrectal object removal, but with difficulties due to its position. Discussion Retained rectal objects are a rare complaint in the emergency department, but with an increasingly important occurrence in recent years. Physical examination should include an assessment of the abdomen and digital rectal examination. Imaging tests are mandatory for diagnosis, with abdominal and pelvis radiography being the most requested. Although there is no consensus on the most appropriate removal technique, less invasive initial approaches are recommended, with transanal removal with a 60–75% success rate under local anesthesia. The follow-up after the procedure depends on several factors, and in general, the patient should be kept under observation and attention should be paid to significant changes in the evolution and alterations in the imaging tests. Conclusion The clinical history in these cases can be confusing, due to the patient's fear of reporting the complaints. Radiography is the best initial test, and CT is reserved for cases of suspected complications. Whenever possible, perform the extraction rectally. Retained rectal objects are a rare complaint in the emergency department. Less invasive initial approaches are recommended. The follow-up after the procedure depends on several factors.
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Management of Asymptomatic Perforation of a Pediatric Rectal Foreign Body into the Peritoneal Cavity Retrieved with Laparoscopy: A Case Report and Review of the Literature. Case Rep Med 2021; 2021:5851967. [PMID: 34876906 PMCID: PMC8645393 DOI: 10.1155/2021/5851967] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 11/15/2021] [Accepted: 11/16/2021] [Indexed: 11/23/2022] Open
Abstract
Rectal foreign body insertion has had an increasing trend throughout the years, whereas it is rarely reported in pediatrics. The management and treatment of these cases can become challenging, since it also can present with atypical or even no symptoms in physical evaluation. A 14-year-old boy was referred to our hospital with a history of insertion of a paintbrush into his anus four weeks before the admission. The paintbrush had perforated the colon and was in the abdominopelvic cavity; however, no symptoms of peritonitis were observed. Rectal examination, sigmoidoscopy, and colonoscopy were unremarkable. Exploratory laparoscopy was performed, and the paintbrush was taken out completely. The patient was discharged in good condition. In cases with rectal foreign body insertion, perforation without causing peritonitis or acute abdomen is possible. In these conditions, imaging examinations play an essential role in managing the patients, and laparoscopy can be a proper procedure for retrieving the foreign body.
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Athamnah MN, Rabai NA, Al Azzam HSO. Rectal foreign body, an impacted plastic ball: A case report and review of literature. Int J Surg Case Rep 2021; 87:106404. [PMID: 34543949 PMCID: PMC8456044 DOI: 10.1016/j.ijscr.2021.106404] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 09/08/2021] [Accepted: 09/10/2021] [Indexed: 10/27/2022] Open
Affiliation(s)
- Mohammad N Athamnah
- Department of General Surgery, Princess Basma Teaching Hospital, Irbid, Jordan.
| | - Nimah A Rabai
- Department of General Surgery, Princess Basma Teaching Hospital, Irbid, Jordan
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Tarasconi A, Perrone G, Davies J, Coimbra R, Moore E, Azzaroli F, Abongwa H, De Simone B, Gallo G, Rossi G, Abu-Zidan F, Agnoletti V, de'Angelis G, de'Angelis N, Ansaloni L, Baiocchi GL, Carcoforo P, Ceresoli M, Chichom-Mefire A, Di Saverio S, Gaiani F, Giuffrida M, Hecker A, Inaba K, Kelly M, Kirkpatrick A, Kluger Y, Leppäniemi A, Litvin A, Ordoñez C, Pattonieri V, Peitzman A, Pikoulis M, Sakakushev B, Sartelli M, Shelat V, Tan E, Testini M, Velmahos G, Wani I, Weber D, Biffl W, Coccolini F, Catena F. Anorectal emergencies: WSES-AAST guidelines. World J Emerg Surg 2021; 16:48. [PMID: 34530908 PMCID: PMC8447593 DOI: 10.1186/s13017-021-00384-x] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 07/16/2021] [Indexed: 02/06/2023] Open
Abstract
Anorectal emergencies comprise a wide variety of diseases that share common symptoms, i.e., anorectal pain or bleeding and might require immediate management. While most of the underlying conditions do not need inpatient management, some of them could be life-threatening and need prompt recognition and treatment. It is well known that an incorrect diagnosis is frequent for anorectal diseases and that a delayed diagnosis is related to an impaired outcome. This paper aims to improve the knowledge and the awareness on this specific topic and to provide a useful tool for every physician dealing with anorectal emergencies.The present guidelines have been developed according to the GRADE methodology. To create these guidelines, a panel of experts was designed and charged by the boards of the World Society of Emergency Surgery (WSES) and American Association for the Surgery of Trauma (AAST) to perform a systematic review of the available literature and to provide evidence-based statements with immediate practical application. All the statements were presented and discussed during the WSES-AAST-WJES Consensus Conference on Anorectal Emergencies, and for each statement, a consensus among the WSES-AAST panel of experts was reached. We structured our work into seven main topics to cover the entire management of patients with anorectal emergencies and to provide an up-to-date, easy-to-use tool that can help physicians and surgeons during the decision-making process.
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Affiliation(s)
- Antonio Tarasconi
- Emergency Surgery Department, Parma University Hospital, Parma, Italy.
| | - Gennaro Perrone
- Emergency Surgery Department, Parma University Hospital, Parma, Italy
| | - Justin Davies
- Cambridge Colorectal Unit, Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - Raul Coimbra
- Riverside University Health System Medical Center, Loma Linda University School of Medicine, Riverside, CA, USA
| | - Ernest Moore
- Ernest E. Moore Shock Trauma Center at Denver Health, Denver, CO, USA
| | - Francesco Azzaroli
- Gastroenterology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy
| | - Hariscine Abongwa
- Emergency Surgery Department, Parma University Hospital, Parma, Italy
| | - Belinda De Simone
- Department of Metabolic, Digestive and Emergency Surgery, Centre Hospitalier Intercommunal de Poissy et Saint Germain en Laye, Poissy, France
| | - Gaetano Gallo
- Department of Medical and Surgical Sciences, University of Catanzaro, Catanzaro, Italy
| | - Giorgio Rossi
- Emergency Surgery Department, Parma University Hospital, Parma, Italy
| | - Fikri Abu-Zidan
- Department of Surgery, College of Medicine and Health Sciences, UAE University, Al-Ain, United Arab Emirates
| | - Vanni Agnoletti
- Anesthesia and Intensive Care Unit, AUSL Romagna, M.Bufalini Hospital, Cesena, Italy
| | - Gianluigi de'Angelis
- Department of Medicine and Surgery, University of Parma, Parma, Italy
- Gastroenterology and Endoscopy Unit, Hospital of Parma, Parma, Italy
| | - Nicola de'Angelis
- Minimally Invasive and Robotic Digestive Surgery Unit, Regional General Hospital F. Miulli, Bari, Ital - Université Paris Est, UPEC, Creteil, France
| | - Luca Ansaloni
- Department of Emergency and general Surgery, Pavia University Hospital, Pavia, Italy
| | - Gian Luca Baiocchi
- Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy
| | - Paolo Carcoforo
- Department of Morphology, Surgery and Experimental Medicine, University of Ferrara, Ferrara, Italy
| | - Marco Ceresoli
- General Surgery, Monza University Hospital, Monza, Italy
| | - Alain Chichom-Mefire
- Faculty of Health Sciences, Department of Surgery, University of Buea, Buea, Cameroon
| | - Salomone Di Saverio
- General surgery 1st unit, Department of General Surgery, University of Insubria, Varese, Italy
| | - Federica Gaiani
- Department of Medicine and Surgery, University of Parma, Parma, Italy
- Gastroenterology and Endoscopy Unit, Hospital of Parma, Parma, Italy
| | - Mario Giuffrida
- Department of Medicine and Surgery, General Surgery Unit, University Hospital of Parma, Parma, Italy
| | - Andreas Hecker
- Department of General & Thoracic Surgery, University Hospital of Giessen, Giessen, Germany
| | - Kenji Inaba
- Division of Acute Care Surgery, University of Southern California, Los Angeles, CA, USA
| | - Michael Kelly
- Department of General Surgery, Albury Hospital, Albury, Australia
| | - Andrew Kirkpatrick
- General, Acute Care, Abdominal Wall Reconstruction, and Trauma Surgery, Foothills Medical Centre, Calgary, Alberta, Canada
| | - Yoram Kluger
- Division of General Surgery, Rambam Health Care Campus, Haifa, Israel
| | | | - Andrey Litvin
- Department of Surgical Disciplines, Regional Clinical Hospital, Immanuel Kant Baltic Federal University, Kaliningrad, Russia
| | - Carlos Ordoñez
- Department of Surgery, Fundacion Valle del Lili - Universidad del Valle, Cali, Colombia
| | | | - Andrew Peitzman
- University of Pittsburgh School of Medicine, UPMC-Presbyterian, Pittsburgh, PA, USA
| | - Manos Pikoulis
- 3rd Department of Surgery, National & Kapodistrian University of Athens, Athens, Greece
| | - Boris Sakakushev
- General Surgery Department, University Hospital St George, Plovdiv, Bulgaria
| | | | - Vishal Shelat
- Department of Surgery, Tan Tock Seng Hospital, Singapore, Singapore
| | - Edward Tan
- Department of Surgery, Department of Emergency Medicine, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Mario Testini
- Academic Unit of General Surgery "V. Bonomo" Department of Biomedical Sciences and Human Oncology, University of Bari, Bari, Italy
| | - George Velmahos
- Division of Trauma, Emergency Surgery, and Surgical Critical Care, Massachusetts General Hospital, Boston, MA, USA
| | - Imtiaz Wani
- Government Gousia Hospital, Srinagar, Kashmir, India
| | - Dieter Weber
- Department of General Surgery, Royal Perth Hospital, University of Western Australia, Perth, Australia
| | - Walter Biffl
- Department of Trauma and Acute Care Surgery, Scripps Memorial Hospital La Jolla, La Jolla, San Diego, CA, USA
| | - Federico Coccolini
- General, Emergency and Trauma Surgery Department, Pisa University Hospital, Pisa, Italy
| | - Fausto Catena
- General, Emergency and Trauma Surgery Dept., Bufalini Hospital, Cesena, Italy
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Gupta SV, Kumar J, Sehgal S, Khemka S. Impacted Large Unusual Rectal Foreign Bodies: a Case Series. Indian J Surg 2021. [DOI: 10.1007/s12262-021-03050-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Mulita F, Theofanis G, Tchabashvili L, Drakos N, Maroulis I. Rectal foreign bodies: retained orange. PRZEGLAD GASTROENTEROLOGICZNY 2021; 16:392-393. [PMID: 34976250 PMCID: PMC8690951 DOI: 10.5114/pg.2021.105409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 03/22/2021] [Indexed: 02/07/2023]
Affiliation(s)
- Francesk Mulita
- Address for correspondence: Dr. Francesk Mulita, Department of Surgery, General University Hospital of Patras, Greece, e-mail:
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8
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Nesemann S, Hubbard KA, Siddiqui MI, Fernandez WG. Rectal Foreign Body Removal in the Emergency Department: A Case Report. Clin Pract Cases Emerg Med 2020; 4:450-453. [PMID: 32926710 PMCID: PMC7434246 DOI: 10.5811/cpcem.2020.7.47237] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 07/03/2020] [Indexed: 11/11/2022] Open
Abstract
Introduction Rectal foreign bodies (RFB) pose a challenge to emergency physicians. Patients are not often forthcoming, which can lead to delays to intervention. Thus, RFBs require a heightened clinical suspicion. In the emergency department (ED), extraction may require creative methods to prevent need for surgical intervention. Case Report The authors present a case of a successful extraction of a RFB in the ED and review of the literature. Conclusion Retained RFBs are an unusually problematic reason for an ED visit. Thus, it is important for emergency physicians to be comfortable managing such cases appropriately.
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Affiliation(s)
- Samuel Nesemann
- University of Texas Health San Antonio, Department of Emergency Medicine, San Antonio, Texas
| | - Kimberly A Hubbard
- University of Texas Health San Antonio Long School of Medicine, Department of Emergency Medicine, San Antonio, Texas
| | - Mehdi I Siddiqui
- University of Texas Health San Antonio Long School of Medicine, Department of Emergency Medicine, San Antonio, Texas
| | - William G Fernandez
- University of Texas Health San Antonio, Department of Emergency Medicine, San Antonio, Texas
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9
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Kim JH, Um E, Jung SM, Shin YC, Jung SW, Kim JI, Heo TG, Lee MS, Jun H, Choi PW. The Management of Retained Rectal Foreign Body. Ann Coloproctol 2020; 36:335-343. [PMID: 32054243 PMCID: PMC7714380 DOI: 10.3393/ac.2019.10.03.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Accepted: 10/03/2019] [Indexed: 12/27/2022] Open
Abstract
Purpose Because insertion of a foreign body (FB) into the anus is considered a taboo practice, patients with a retained rectal FB may hesitate to obtain medical care, and attending surgeons may lack experience with removing these FBs. We performed this study to evaluate the clinical characteristics of Korean patients with a retained rectal FB and propose management guideline for such cases based on our experience. Methods We retrospectively investigated 14 patients between January 2006 and December 2018. We assessed demographic features, mechanism of FB insertion, clinical course between diagnosis and management, and outcomes. Results All patients were male (mean age, 43 years) and presented with low abdominal pain (n = 2), anal bleeding (n = 2), or concern about a retained rectal FB without symptoms (n = 10). FB insertion was most commonly associated with sexual gratification or anal eroticism (n = 11, 78.6%). All patients underwent general anesthesia for anal sphincter relaxation with the exception of 2 who underwent FB removal in the emergency department. FBs were retrieved transanally using a clamp (n = 2), myoma screw (n = 1), clamp application following abdominal wall compression (n = 2), or laparotomy followed by rectosigmoid colon milking (n = 2). Colotomy and primary repair were performed in four patients, and Hartmann operation was performed in one patient with fecal peritonitis. No morbidity or mortality was reported. All patients refused postextraction anorectal functional and anatomical evaluation and psychological counseling. Conclusion Retained rectal FB is rare; however, colorectal surgeons should be aware of the various methods that can be used for FB retrieval and the therapeutic algorithm applicable in such cases.
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Affiliation(s)
- Ju Hun Kim
- Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Eunhae Um
- Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Sung Min Jung
- Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Yong Chan Shin
- Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Sung-Won Jung
- Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Jae Il Kim
- Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Tae Gil Heo
- Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Myung Soo Lee
- Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Heungman Jun
- Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
| | - Pyong Wha Choi
- Department of Surgery, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, Korea
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Mohamad IS, Yaacob H. An Aubergine in My … Case of Rectal Foreign Body. MALAYSIAN FAMILY PHYSICIAN : THE OFFICIAL JOURNAL OF THE ACADEMY OF FAMILY PHYSICIANS OF MALAYSIA 2018; 13:47-48. [PMID: 30800236 PMCID: PMC6382087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
A 24-year-old man presented to the casualty department with a history of left-sided, colicky abdominal pain for one day. It was associated with an inability to pass flatus or motion within the same duration. There was no history of vomiting. On examination, the vital signs were within normal limits, and he was afebrile. His abdomen was soft, but a hard mass was palpable on the left side of his abdomen. There was no peritonitis. The bowel sounds were sluggish.
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Affiliation(s)
- I S Mohamad
- MD (USM), MMed (surgery) USM Department of Surgery Universiti Sains Malaysia Malaysia
| | - H Yaacob
- MD (USM), MMed (surgery) USM Department of Surgery Universiti Sains Malaysia Malaysia
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11
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Farkas NG, Welman TJP, Ross T, Brown S, Smith JJ, Pawa N. Unusual causes of large bowel obstruction. Curr Probl Surg 2018; 56:49-90. [PMID: 30777150 DOI: 10.1067/j.cpsurg.2018.12.001] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Accepted: 12/10/2018] [Indexed: 12/17/2022]
Affiliation(s)
- Nicholas G Farkas
- West Middlesex University Hospital, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK.
| | - Ted Joseph P Welman
- West Middlesex University Hospital, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | - Talisa Ross
- West Middlesex University Hospital, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | - Sarah Brown
- West Middlesex University Hospital, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | - Jason J Smith
- West Middlesex University Hospital, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
| | - Nikhil Pawa
- West Middlesex University Hospital, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK
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12
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McCombe AJ, Frankel AJ, Morris B. Pneumatic oscillating microsagittal saw: a novel method for removal of a rectal foreign body. ANZ J Surg 2018; 89:E446-E447. [PMID: 29895101 DOI: 10.1111/ans.14739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 05/14/2018] [Accepted: 05/22/2018] [Indexed: 11/30/2022]
Affiliation(s)
| | - Adam J Frankel
- Princess Alexandra Hospital, Brisbane, Queensland, Australia
| | - Bradley Morris
- Princess Alexandra Hospital, Brisbane, Queensland, Australia
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13
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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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Robertson WJ. 'Believe it or not': the medical framing of rectal foreign bodies. CULTURE, HEALTH & SEXUALITY 2017; 19:815-828. [PMID: 28060572 DOI: 10.1080/13691058.2016.1263874] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Medical and lay attention to and intervention for rectal foreign bodies, the presence of an object in the rectum most often via insertion through the anus, has long been a source of humour and suspicion in both medical and public discourses. How do the ways medical providers write and talk to each other about rectal foreign bodies shape and reflect understandings of gender, sexuality and the (im)proper use of the anus and rectum? This paper examines the medical literature on rectal foreign bodies to shed light on the ways in which medical providers frame rectal foreign bodies. It develops a set of six frames that demonstrate how the medical literature on rectal foreign bodies (re)produces a variety of normative assumptions about and sociocultural values concerning bodies and sexuality, danger, shame, deception, mental illness and medical professionalism. It concludes with a discussion of how these framings of rectal foreign bodies might potentially contribute to the ongoing stigmatisation not only of rectal foreign body patients, but of non-heteronormative sexualities in general.
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Cawich SO, Thomas DA, Mohammed F, Bobb NJ, Williams D, Naraynsingh V. A Management Algorithm for Retained Rectal Foreign Bodies. Am J Mens Health 2017; 11:684-692. [PMID: 27903951 PMCID: PMC5675215 DOI: 10.1177/1557988316680929] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 10/26/2016] [Accepted: 10/31/2016] [Indexed: 01/25/2023] Open
Abstract
Few authors have proposed therapeutic protocols to manage retained rectal foreign bodies (RFBs). All patients with retained RFBs in hospitals across Trinidad and Tobago over 5 years were identified. Hospital records were retrieved and manually reviewed to extract the following data: demographics, history, foreign body retrieved, clinical signs at presentation, management strategy, duration of hospitalization, and morbidity and mortality. There were 10 patients with RFBs over the study period. The annual incidence of this phenomenon was 0.15 per 100,000 population. All patients were men at a mean age of 50.6 years (range: 27-83; SD = 15.3) who presented after a voluntary delay of 1.4 days (range: 0.5-2.5; SD = 0.7). Only one patient gave an accurate history on presentation, but all eventually admitted to self-insertion for sexual gratification. At presentation, one patient had a spontaneous rectal perforation (10%). The remaining nine patients had attempts at bedside transanal extraction, which was unsuccessful in 89% (8/9) of cases. The RFB was pushed beyond the grasp of forceps, making removal under anesthesia unsuccessful in 62.5% (5/8) cases. These patients required more invasive extraction methods including transanal minimally invasive surgery (1), laparoscopic-assisted advancement with transanal retrieval (1), and open surgery with transmural extraction and anastomoses (3). A management algorithm is proposed for the management of RFBs. Important points in this algorithm are the importance of clinician-patient rapport, early surgical referral, avoidance of bedside extraction in the emergency room, early examination under anesthesia, and the inclusion of emerging therapies such as transanal minimally invasive surgery.
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Affiliation(s)
- Shamir O. Cawich
- The University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Dexter A. Thomas
- The University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Fawwaz Mohammed
- The University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Nahmorah J. Bobb
- The University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Dorothy Williams
- The University of the West Indies, St. Augustine, Trinidad and Tobago
| | - Vijay Naraynsingh
- The University of the West Indies, St. Augustine, Trinidad and Tobago
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Khubezov DA, Trushin SN, Puchkov KV, Puchkov DK, Ogorel'tsev AY. [Treatment of rectal foreign bodies]. Khirurgiia (Mosk) 2016:57-63. [PMID: 27723697 DOI: 10.17116/hirurgia2016957-63] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIM to present the results of treatment of rectal foreign bodies. MATERIAL AND METHODS 15-year outcomes of 112 patients with rectal foreign bodies were analyzed. RESULTS Outpatient and hospital care were applied in 52 (46%) and 60 (54%) of cases respectively. Transanal removal was made in 97 (87%) patients including 28 (25%) cases of general anaesthesia. 14 (13%) patients underwent surgery. Colostomy was performed in 7 (6%) cases. We presented cases of foreign bodies removal through laparotomy, colotomy and SILS-assisted transanal approach. DISCUSSION From clinical point of view foreign bodies should be first of all classified by their dimensions. Anamnesis and physical examination are very important. Abdominal X-ray survey is obligatory. Transanal removal under general anaesthesia is advisable if perforation is absent. If such procedure is impossible laparotomy is indicated. CONCLUSION Algorithm of survey and treatment is presented.
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Affiliation(s)
- D A Khubezov
- Pavlov Ryazan State Medical University, Health Ministry of the Russian Federation ,Regional Clinical Hospital, Ryazan, Russia
| | - S N Trushin
- Pavlov Ryazan State Medical University, Health Ministry of the Russian Federation ,Regional Clinical Hospital, Ryazan, Russia
| | - K V Puchkov
- Pavlov Ryazan State Medical University, Health Ministry of the Russian Federation ,Regional Clinical Hospital, Ryazan, Russia
| | - D K Puchkov
- Pavlov Ryazan State Medical University, Health Ministry of the Russian Federation ,Regional Clinical Hospital, Ryazan, Russia
| | - A Yu Ogorel'tsev
- Pavlov Ryazan State Medical University, Health Ministry of the Russian Federation ,Regional Clinical Hospital, Ryazan, Russia
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17
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Yahya A, Chukwuma J. Retrospective Audit of the Management of Anal Insertion of Foreign Bodies: A Holistic Approach. Prim Care Companion CNS Disord 2016; 18:15br01864. [PMID: 27247831 DOI: 10.4088/pcc.15br01864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2015] [Accepted: 10/07/2015] [Indexed: 10/22/2022] Open
Abstract
Most patients with voluntary anal insertion of a foreign body (IFB) present to the emergency department and are then managed by the surgical team. This report reviews the medical literature on IFB and includes results of a chart review of operative logged interventions and clinically coded procedures for anal IFBs at a single acute hospital in the United Kingdom between May 2009 and September 2013. The objective was to establish the current practice in the management of anal IFB and update a framework for the initial workup, surgical procedure, and appropriate mental health intervention.
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Affiliation(s)
- Ahmed Yahya
- Department of Psychiatry, Chase Farm Hospital, Barnet, Enfield and Haringey Mental Health NHS Trust, Middlesex, United Kingdom
| | - Jude Chukwuma
- Department of Psychiatry, Chase Farm Hospital, Barnet, Enfield and Haringey Mental Health NHS Trust, Middlesex, United Kingdom
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18
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Pathak R, Karmacharya P, Alweis RL. Seasonal Variation of Rectal Foreign Bodies: Data from Nationwide Inpatient Sample. NORTH AMERICAN JOURNAL OF MEDICAL SCIENCES 2016; 8:191-3. [PMID: 27213144 PMCID: PMC4866476 DOI: 10.4103/1947-2714.179959] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Background: Seasonality is noted in various aspects of human behavior and functioning which have led to an increasing interest in their seasonality in the recent years. Aims: We aimed to examine the seasonal variation in the incidence of rectal foreign bodies in the US using a large inpatient database. Methods: We used the Nationwide Inpatient Sample database to identify patients aged ≥18 years admitted with a primary diagnosis of the rectal foreign body from 2009 to 2011. We used the Edward's recognition and estimation of cyclic trend method to study the seasonal variation of the incidence of rectal foreign body and Z-test to compare the seasonal incidences. Results: A total of 3359 hospitalizations with primary diagnosis of the rectal foreign body were reported from 2009 to 2011. The peak incidence of rectal foreign bodies was seen in October (peak/low ratio 1.20, 95% confidence interval [CI]: 1.10–1.32). Conclusion: Data on seasonal variation of rectal foreign bodies are extremely limited. Further studies would be required to verify whether our findings of a higher incidence in the fall season are reflective of acute changes in the length of the days, climate, sleep-wake cycle, or decreased sexual intercourse at this time of the year. High suspicion at this time of the year may help promptly diagnose and avoid unnecessary investigations.
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Affiliation(s)
- Ranjan Pathak
- Department of Internal Medicine , Reading Health System , West Reading, Pennsylvania , USA
| | - Paras Karmacharya
- Department of Internal Medicine , Reading Health System , West Reading, Pennsylvania , USA
| | - Richard L Alweis
- Department of Internal Medicine , Reading Health System , West Reading, Pennsylvania , USA
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19
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Unexpected Radiologic Findings for a Casting Type of Radiolucent Colorectal Foreign Body Composed of Polyurethane Foam. Case Rep Radiol 2016; 2016:4987105. [PMID: 27213072 PMCID: PMC4860242 DOI: 10.1155/2016/4987105] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 04/10/2016] [Indexed: 11/30/2022] Open
Abstract
Radiologic diagnosis of colorectal foreign bodies is usually not very difficult, because inserted materials are often clearly visible on plain abdominal radiographs. However, when they are radiolucent, a plain abdominal radiograph has been reported to be useless. As radiolucent colorectal foreign bodies appear as radiolucent artificial contours or air-trapped materials in the pelvis, almost always the diagnosis itself can be made by careful evaluation of plain abdominal radiographs. We encountered a case of casting type of radiolucent colorectal foreign body formed from polyurethane foam. It presented us with unexpected radiologic findings and led to diagnostic difficulties.
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20
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Alharbi MB. Intentional impaction of rectum by mattress sponge pieces (foreign bodies) leading to intestinal obstruction in a mentally ill patient: Case report and literature review. INTERNATIONAL JOURNAL OF SURGERY OPEN 2016. [DOI: 10.1016/j.ijso.2016.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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21
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Imaging Foreign Bodies: Ingested, Aspirated, and Inserted. Ann Emerg Med 2015; 66:570-582.e5. [DOI: 10.1016/j.annemergmed.2015.07.499] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2015] [Revised: 07/07/2015] [Accepted: 07/15/2015] [Indexed: 12/27/2022]
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22
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Lim KJ, Kim JS, Kim BG, Park SM, Ji JS, Kim BW, Choi H. Removal of Rectal Foreign Bodies Using Tenaculum Forceps Under Endoscopic Assistance. Intest Res 2015; 13:355-9. [PMID: 26576143 PMCID: PMC4641864 DOI: 10.5217/ir.2015.13.4.355] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Revised: 10/13/2014] [Accepted: 10/16/2014] [Indexed: 12/25/2022] Open
Abstract
The incidence of rectal foreign bodies is increasing by the day, though not as common as that of upper gastrointestinal foreign bodies. Various methods for removal of foreign bodies have been reported. Removal during endoscopy using endoscopic devices is simple and safe, but if the foreign body is too large to be removed by this method, other methods are required. We report two cases of rectal foreign body removal by a relatively simple and inexpensive technique. A 42-year-old man with a vibrator in the rectum was admitted due to inability to remove it by himself and various endoscopic methods failed. Finally, the vibrator was removed successfully by using tenaculum forceps under endoscopic assistance. Similarly, a 59-year-old man with a carrot in the rectum was admitted. The carrot was removed easily by using the same method as that in the previous case. The use of tenaculum forceps under endoscopic guidance may be a useful method for removal of rectal foreign bodies.
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Affiliation(s)
- Keun Joon Lim
- Department of Internal Medicine, The Catholic University of Korea, Incheon St.Mary's Hospital, Incheon, Korea
| | - Joon Sung Kim
- Department of Internal Medicine, The Catholic University of Korea, Incheon St.Mary's Hospital, Incheon, Korea
| | - Boo Gyoung Kim
- Department of Internal Medicine, The Catholic University of Korea, Incheon St.Mary's Hospital, Incheon, Korea
| | - Sung Min Park
- Department of Internal Medicine, The Catholic University of Korea, Incheon St.Mary's Hospital, Incheon, Korea
| | - Jeong-Seon Ji
- Department of Internal Medicine, The Catholic University of Korea, Incheon St.Mary's Hospital, Incheon, Korea
| | - Byung-Wook Kim
- Department of Internal Medicine, The Catholic University of Korea, Incheon St.Mary's Hospital, Incheon, Korea
| | - Hwang Choi
- Department of Internal Medicine, The Catholic University of Korea, Incheon St.Mary's Hospital, Incheon, Korea
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23
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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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24
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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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25
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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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