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ALsannaa F, Bin Saleem R, ALowayyid J. Rectum Perforation Secondary to Ingested Chicken Bone Presenting as Peri-Anal Abscess: A Case Report. Cureus 2023; 15:e49673. [PMID: 38161867 PMCID: PMC10756655 DOI: 10.7759/cureus.49673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2023] [Indexed: 01/03/2024] Open
Abstract
Rectal perforation secondary to an ingested foreign body is a rare occurrence that can be challenging to diagnose. It may initially present as a perianal abscess. Herein, we report a rare incident involving a patient who presented with a perianal abscess. The initial assessment and an abdominal CT scan revealed a large horseshoe perianal abscess with a small linear hyperdensity noted near the anal verge. The patient was taken to the operating room, where he was found to have perforated the rectum due to an ingested chicken bone. The procedure involved the incision and drainage of the abscess, along with the removal of the foreign body.
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Affiliation(s)
- Feras ALsannaa
- Trauma and Acute Care Surgery, Prince Sultan Military Medical City, Riyadh, SAU
| | - Reem Bin Saleem
- General Surgery, Prince Sultan Military Medical City, Riyadh, SAU
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Satheakeerthy S, Tang H, Arafat Y, Udayasiri D, Yeung JM. Perineal necrotizing soft tissue infection secondary to rectal perforation from a large fish bone -a painful lesion not to be missed. Radiol Case Rep 2023; 18:2011-2013. [PMID: 37006838 PMCID: PMC10060143 DOI: 10.1016/j.radcr.2023.03.011] [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: 02/04/2023] [Revised: 03/01/2023] [Accepted: 03/03/2023] [Indexed: 04/04/2023] Open
Abstract
Necrotizing soft tissue infection caused by a large 70 mm fish bone that led to a single perforation of the rectum is an incredibly rare phenomenon. We report a case of an adult male in his 50s who presented with perianal pain. A prompt computed tomography (CT) scan revealed a foreign body had perforated through the rectum into the retrorectal space with associated gas locules, indicating a necrotizing infection. In addition, our case report explores the principles of wide exploration and debridement, the role of a defunctioning colostomy in perineal wound management, and principles of wound closure in the context of a foreign body causing significant perineal sepsis.
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Affiliation(s)
- Shriranshini Satheakeerthy
- Department of General Surgery, Western Health, Footscray Hospital, 160 Gordon St, Footscray, VIC 3011, Australia
| | - Howard Tang
- Department of General Surgery, Western Health, Footscray Hospital, 160 Gordon St, Footscray, VIC 3011, Australia
| | - Yasser Arafat
- Department of Colorectal Surgery, Western Health, Footscray Hospital, 160 Gordon St, Footscray, VIC 3011, Australia
- University of Melbourne, Victoria, Australia
| | - Dilshan Udayasiri
- Department of Colorectal Surgery, Western Health, Footscray Hospital, 160 Gordon St, Footscray, VIC 3011, Australia
- University of Melbourne, Victoria, Australia
| | - Justin Mc Yeung
- Department of Colorectal Surgery, Western Health, Footscray Hospital, 160 Gordon St, Footscray, VIC 3011, Australia
- Department of Surgery, Western Precinct, University of Melbourne, Victoria, Australia
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Yin H, Luo B, Wang Q, Hong Z, Chen H, Shen L, Shen B, Hu B. Differences in Gut Microbiota between Healthy Individuals and Patients with Perianal Abscess before and after Surgery. Mediators Inflamm 2023; 2023:1165916. [PMID: 37091905 PMCID: PMC10115528 DOI: 10.1155/2023/1165916] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2022] [Revised: 03/13/2023] [Accepted: 03/29/2023] [Indexed: 04/25/2023] Open
Abstract
Surgery is the most important treatment for perianal abscesses. However, the gut microbiota of patients with perianal abscess and the effects of perianal abscess on the gut microbiota after surgery are unknown. In this study, significant changes in interleukin 6 and tumor necrosis factor-α in the blood of healthy subjects, patients with perianal abscesses, and patients after perianal abscess surgery were identified. 16S rRNA gene sequencing technology was used to detect the changes in the gut microbiota among 30 healthy individuals and 30 patients with perianal abscess before and after surgery. Venn diagrams and alpha diversity analyses indicated differences in the abundance and uniformity of gut microbiota between the healthy individuals and patients with perianal abscesses before and after surgery. Beta diversity analysis indicated that the grouping effects among the control, abscess, and surgery groups were good. The classification and compositional analysis showed significant differences in the gut microbiota between healthy individuals and patients with perianal abscesses before and after surgery. LEfSe analysis, random forest analysis, and ROC curve analysis showed that Klebsiella (AUC = 0.7467) and Bilophila (AUC = 0.72) could be potential biomarkers for the diagnosis of perianal abscess. The functional prediction results showed that the differential microbiota is significantly enriched in the pathways related to nutrition and drug metabolism. This study may have important implications for the clinical management and prognostic assessment of patients with perianal abscesses.
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Affiliation(s)
- Hezhai Yin
- Department of Surgery, Jiaxing Hospital of Traditional Chinese Medicine, Zhejiang Chinese Medical University, Jiaxing, 314001 Zhejiang, China
| | - Bairu Luo
- Department of Clinical Pathology, Jiaxing University Master Degree Cultivation Base, Jiaxing Hospital of Traditional Chinese Medicine, Zhejiang Chinese Medical University, Jiaxing, 314001 Zhejiang, China
| | - Qi Wang
- Department of Surgery, Jiaxing Hospital of Traditional Chinese Medicine, Zhejiang Chinese Medical University, Jiaxing, 314001 Zhejiang, China
| | - Zhonghua Hong
- Department of Surgery, Jiaxing Hospital of Traditional Chinese Medicine, Zhejiang Chinese Medical University, Jiaxing, 314001 Zhejiang, China
| | - Huilin Chen
- Department of Surgery, Jiaxing Hospital of Traditional Chinese Medicine, Zhejiang Chinese Medical University, Jiaxing, 314001 Zhejiang, China
| | - Lidong Shen
- Department of Surgery, Jiaxing Hospital of Traditional Chinese Medicine, Zhejiang Chinese Medical University, Jiaxing, 314001 Zhejiang, China
| | - Bin Shen
- Department of Surgery, Jiaxing Hospital of Traditional Chinese Medicine, Zhejiang Chinese Medical University, Jiaxing, 314001 Zhejiang, China
| | - Bo Hu
- Department of Surgery, Jiaxing Hospital of Traditional Chinese Medicine, Zhejiang Chinese Medical University, Jiaxing, 314001 Zhejiang, China
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Pesky Pesce: A Forgettable Fish Dinner with a Late Surprise, a Perianal Abscess. Dig Dis Sci 2022; 67:4369-4372. [PMID: 35857242 DOI: 10.1007/s10620-022-07625-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/06/2022] [Indexed: 12/09/2022]
Abstract
Clinical presentation after ingestion of foreign body is a common finding in surgical practice. Perianal sepsis due to a foreign body is, usually, secondary to introduction via the trans-anal route. The case here reported is extremely rare since an ingested fishbone passed asymptomatically through most of the gastrointestinal tract, with resultant late-onset ischiorectal abscess. Moreover, clinical evidence of the perianal abscess manifested one month after the fishbone had been ingested. The final localization of the fishbone-lying anterior to the sacrum-complicated the preoperative and intraoperative detection of the ingested foreign body.
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