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Lin CY, Pu TW. Colon perforation with severe peritonitis caused by erotic toy insertion and treated using vacuum-assisted closure: A case report. World J Clin Cases 2024; 12:3548-3554. [DOI: 10.12998/wjcc.v12.i18.3548] [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: 02/27/2024] [Revised: 04/22/2024] [Accepted: 05/06/2024] [Indexed: 06/13/2024] Open
Abstract
BACKGROUND Colorectal foreign bodies are commonly encountered during surgery. They are frequently observed in men 20 to 90 years of age and have bimodal age distribution. Surgical management is necessary for cases of rectal perforation. However, surgical site infections are the most common complications after colorectal surgery.
CASE SUMMARY We discuss a case of rectal perforation in a patient who presented to our hospital 2 d after its occurrence. The perforation occurred as a result of the patient inserting a sex toy in his rectum. Severe peritonitis was attributable to delayed presentation.
CONCLUSION Vacuum-assisted closure was performed to treat the wound, which healed well after therapy. No complications were noted.
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Affiliation(s)
- Cheng-You Lin
- Department of Surgery, Division of Colon and Rectal Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei 114, Taiwan
- Department of Surgery, Taichung Armed Force General Hospital, Taichung 411, Taiwan
| | - Ta-Wei Pu
- Division of Colon and Rectal Surgery, Department of Surgery, Tri-Service General Hospital Songshan branch, National Defense Medical Center, Taipei 105, Taiwan
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2
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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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3
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Frendt E, Masroor M, Saied A, Neeki A, Youssoffi S, Malkoc A, Dong F, Tran L, Borger R, Wong DT, Neeki M. Characteristics and Outcomes Associated With Emergent Rectal Foreign Body Management: A Retrospective Cohort Analysis. Cureus 2023; 15:e49413. [PMID: 38149151 PMCID: PMC10750084 DOI: 10.7759/cureus.49413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/25/2023] [Indexed: 12/28/2023] Open
Abstract
Background Bedside management and outcomes of rectal foreign bodies remain challenging due to the presentation and complexity of the inserted objects. Injuries, such as perforation of the colon and rectum, are among the most commonly reported complications. However, prior studies are unclear regarding the setting in which the complication rates may be minimized. This study aimed to assess whether there was a statistically significant difference among the various extraction methods with regard to complications in the emergency department and operating room. Materials and methods This was a retrospective study of all cases of rectal foreign bodies that were removed in the emergency department at a large county hospital between 1/1/2010 and 12/31/2020. Patients included in this study were adults who were evaluated and treated in the emergency department. Results A total of 78 patients were included in the final analysis. More than half (51.3%, n=40) of the patients were successfully treated in the emergency department. Compared with the emergency department, patients in the operating room were more likely to undergo exploratory laparotomy and colectomy (0% vs. 31.6%, p<0.0001), undergo general anesthesia (84.2% vs. 0%, p<0.0001), have higher complication rates (21% vs. 0%, p=0.0021), and have a longer hospital length of stay (median=1 vs. 0, p<0.0001). Conclusion This study revealed a >50% success rate of rectal foreign body removal in the emergency department without any reported complications. To improve the success rate of bedside retrieval and decrease complications, physicians need to be vigilant, communicative, and compassionate about their evaluations and clinical methodology.
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Affiliation(s)
- Eric Frendt
- Emergency Department, Arrowhead Regional Medical Center, Colton, USA
| | - Momin Masroor
- Emergency Department, California University of Science and Medicine, Colton, USA
| | - Arman Saied
- Emergency Department, California University of Science and Medicine, Colton, USA
| | - Arianna Neeki
- Emergency Department, Arrowhead Regional Medical Center, Colton, USA
| | - Santana Youssoffi
- Emergency Department, California University of Science and Medicine, Colton, USA
| | - Aldin Malkoc
- Surgery, Arrowhead Regional Medical Center, Colton, USA
| | - Fanglong Dong
- Emergency Department, Arrowhead Regional Medical Center, Colton, USA
| | - Louis Tran
- Emergency Department, Arrowhead Regional Medical Center, Colton, USA
| | - Rodney Borger
- Emergency Department, Arrowhead Regional Medical Center, Colton, USA
| | - David T Wong
- Surgery, Arrowhead Regional Medical Center, Colton, USA
| | - Michael Neeki
- Emergency Department, California University of Science and Medicine, Colton, USA
- Emergency Department, Arrowhead Regional Medical Center, Colton, USA
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4
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Successful Expulsion of a Golf Ball from the Sigmoid Colon Using Volume Laxatives. Case Rep Surg 2023; 2023:5841246. [PMID: 36644551 PMCID: PMC9839405 DOI: 10.1155/2023/5841246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 04/15/2022] [Accepted: 12/19/2022] [Indexed: 01/07/2023] Open
Abstract
Background Rectal foreign bodies form a surprisingly frequent cause of presentation to the emergency department. The materials inserted constitute a wide range of size, shape, and texture with each presenting a unique set of challenges. Despite a seemingly innocuous presentation, if not recognised early and managed accordingly, significant complications can develop including obstruction, perforation, and sphincteric injury. The existing doctrines advocate endoscopic intervention after simple measures fail and advise against the use of laxative therapy due to concerns for complications that may arise. The authors of this study challenge this notion, provided certain conditions are met. Case Presentation. We report the case of a 14-year-old boy who inserted a golf ball into his rectum, which subsequently migrated proximally into the sigmoid colon on plain radiographic films. The patient was asymptomatic on presentation, and there was no clinical evidence of bowel injury or mechanical bowel obstruction. Endoscopic removal of the golf ball was pursued under general anaesthesia. Despite protracted efforts, the golf ball was not able to be retrieved endoscopically. In an attempt to avoid aggressive surgery, volume laxatives were administered with successful passage of the golf ball several hours later. Conclusions This case discusses the unique technical challenges, which may be encountered when attempting to retrieve a large, spherical, and non-confirming foreign body entrapped above the rectosigmoid junction and how these factors can complicate endoscopic retrieval. The authors advocate that in the absence of a mechanical bowel obstruction, patients with foreign bodies possessing physical properties that are amenable to spontaneous passage, a trial of strong aperients, should be considered first line. The author's contention is that direct escalation to removal of foreign body in theatre can be resource draining and may expose the patient to additional risk.
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5
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Zhang Y, Han Y, Xu H, Chen D, Gao H, Yuan H, Zeng X. A retrospective analysis of transanal surgical management of 291 cases with rectal foreign bodies. Int J Colorectal Dis 2022; 37:2167-2172. [PMID: 36057731 DOI: 10.1007/s00384-022-04230-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/29/2022] [Indexed: 02/04/2023]
Abstract
BACKGROUND Rectal foreign bodies (RFB) are quite uncommon except in very busy hospitals. Because of their rarity, it is seldom that the treating physicians have a standard approach to the diagnosis, technique of extraction, and post-extraction evaluation. This can be further complicated by the rather extreme variability of size, shape, and texture of the foreign bodies, as well as the potential extent of trauma to the rectum or distal colon. AIM The objectives of this study were to delineate the demographics, classification of cause, and injury patterns of RFB and to present the results of the transanal surgical management of a large series of RFB. METHODS We retrospectively collected extensive data from the hospital medical records of the 291 patients who presented with RFB to the emergency department of Shenyang Proctological Hospital (Shenyang, China) from 2012 July to 2020 December. Specifically, demographics, origins and circumstance of the RFB, complications, injuries, anesthesia method, and the results of the transanal surgical management were recorded and analyzed. RESULTS Of the 291 RFB cases, 225 (77.3%) were male and 66 (22.7%) were female, with a mean age of 53.8 ± 15.5 years (range, 1 ~ 88 years). The circumstances of the RFB were categorized as swallowed, 199 cases (68.4%); self-inserted, 87 (29.9%); and iatrogenic, 5 (1.7%). The proportion of males in the self-inserted RFB group was significantly greater than the swallowed RFB group (t = 31.114, p = 0.000). In the swallowed RFB group, the most common anorectal injuries and pathological changes were the following: penetration into the mucosa (75 cases, 37.7%), perianal or submucosal abscess (27 cases, 13.6%), and penetration into the anal canal (18 cases, 9.0%). In the self-inserted RFB group, 64 (73.6%) of the 87 cases had an intact rectum, whereas 8 (9.2%) had rectal mucosal ulcers and bleeding, and 7 (8%) had rectal lacerations. In the iatrogenic RFB group, 3 cases (60%) had rectal mucosal ulcers and bleeding, and 2 cases (40%) had inflammation of the rectal mucosa. Regarding extraction procedures, in the swallowed group, 187(187/199; 94%) patients underwent a transanal surgical procedure, and all were successful. In the self-inserted group, 82 patients underwent the transanal surgical procedure, and 74 (74/82; 90.2%) were successful whereas it was unsuccessful in the remaining 8 patients (8/82, 9.8%). Three (3/4, 75%) patients with iatrogenic RFB were resolved by the transanal surgical procedure. CONCLUSION Men were markedly more likely than women to have swallowed RFBs and self-inserted RFBs. No serious damage to the rectum and anus was found in cases of swallowed RFB. Moreover, most surgical operations to remove foreign bodies via the anus were successful in this category of RFB. In contrast, rectal injury was more severe in patients with self-inserted RFB, such as rectal laceration, rectal mucosal ulcer, and bleeding. Moreover, the transanal removal operation in patients with self-inserted RFB had a failure rate of nearly 10%. Thick, long, hard foreign bodies did present a great challenge to the operator. Therefore, if necessary, patients with foreign bodies may need to be promptly referred for transabdominal removal.
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Affiliation(s)
- Yong Zhang
- Department of Anorectal Disease, Shenyang Coloproctology Hospital, 9th of North Nanjing Street, Heping District, Shenyang, 110002, China.
| | - Yi Han
- Department of Anorectal Disease, Shenyang Coloproctology Hospital, 9th of North Nanjing Street, Heping District, Shenyang, 110002, China
| | - Huimian Xu
- Department of Surgical Oncology and General Surgery, The First Hospital of China Medical University, 155th of North Nanjing Street, Heping District, Shenyang, 110001, China
| | - Deyu Chen
- Department of Anorectal Disease, Shenyang Coloproctology Hospital, 9th of North Nanjing Street, Heping District, Shenyang, 110002, China
| | - Hongjian Gao
- Department of Anorectal Disease, Shenyang Coloproctology Hospital, 9th of North Nanjing Street, Heping District, Shenyang, 110002, China
| | - Hexue Yuan
- Department of Anorectal Disease, Shenyang Coloproctology Hospital, 9th of North Nanjing Street, Heping District, Shenyang, 110002, China
| | - Xiandong Zeng
- Health Commission of Shenyang, 13th of Beiqi Street, Heping District, Shenyang, 110003, China
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Fritz S, Killguss H, Schaudt A, Sommer CM, Richter GM, Belle S, Reissfelder C, Loff S, Köninger J. Proposal of an algorithm for the management of rectally inserted foreign bodies: a surgical single-center experience with review of the literature. Langenbecks Arch Surg 2022; 407:2499-2508. [PMID: 35654873 DOI: 10.1007/s00423-022-02571-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 05/24/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Retained rectal foreign bodies (RFBs) are uncommon clinical findings. Although the management of RFBs is rarely reported in the literature, clinicians regularly face this issue. To date, there is no standardized management of RFBs. The aim of the present study was to evaluate our own data and subsequently develop a treatment algorithm. METHODS All consecutive patients who presented between January 2006 and December 2019 with rectally inserted RFBs at the emergency department of the Klinikum Stuttgart, Germany, were retrospectively identified. Clinicopathologic features, management, complications, and outcomes were assessed. Based on this experience, a treatment algorithm was developed. RESULTS A total of 69 presentations with rectally inserted RFBs were documented in 57 patients. In 23/69 cases (33.3%), the RFB was removed transanally by the emergency physician either digitally (n = 14) or with the help of a rigid rectoscope (n = 8) or a colonoscope (n = 1). In 46/69 cases (66.7%), the RFB was removed in the operation theater under general anesthesia with muscle relaxation. Among these, 11/46 patients (23.9%) underwent abdominal surgery, either for manual extraction of the RFB (n = 9) or to exclude a bowel perforation (n = 2). Surgical complications occurred in 3/11 patients. One patient with rectal perforation developed pelvic sepsis and underwent abdominoperineal extirpation in the further clinical course. CONCLUSION The management of RFBs can be challenging and includes a wide range of options from removal without further intervention to abdominoperineal extirpation in cases of pelvic sepsis. Whenever possible, RFBs should obligatorily be managed in specialized colorectal centers following a clear treatment algorithm.
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Affiliation(s)
- Stefan Fritz
- Department of General, Visceral, Thoracic, and Transplantation Surgery, Klinikum Stuttgart, Kriegsbergstraße 60, 70174, Stuttgart, Germany.
- Department of Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
- Deutsches End- und Dickdarmzentrum, Mannheim, Germany.
| | - Hansjörg Killguss
- Department of General, Visceral, Thoracic, and Transplantation Surgery, Klinikum Stuttgart, Kriegsbergstraße 60, 70174, Stuttgart, Germany
| | - André Schaudt
- Department of General, Visceral, Thoracic, and Transplantation Surgery, Klinikum Stuttgart, Kriegsbergstraße 60, 70174, Stuttgart, Germany
| | - Christof M Sommer
- Department of Diagnostic and Interventional Radiology, Klinikum Stuttgart, Stuttgart, Germany
| | - Götz M Richter
- Department of Diagnostic and Interventional Radiology, Klinikum Stuttgart, Stuttgart, Germany
| | - Sebastian Belle
- Department of Medicine II, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Christoph Reissfelder
- Department of Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Steffan Loff
- Department of Pediatric Surgery, Klinikum Stuttgart, Stuttgart, Germany
| | - Jörg Köninger
- Department of General, Visceral, Thoracic, and Transplantation Surgery, Klinikum Stuttgart, Kriegsbergstraße 60, 70174, Stuttgart, Germany
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7
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Paduano D, Auriemma F, Bianchetti M, Repici A, Mangiavillano B. Bike handlebar grip in the rectum: minimally invasive endoscopic management. Endoscopy 2022; 54:E42-E43. [PMID: 33682900 DOI: 10.1055/a-1362-9026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- Danilo Paduano
- Gastrointestinal Endoscopy Unit, Humanitas Mater Domini, Castellanza, Italy
| | - Francesco Auriemma
- Gastrointestinal Endoscopy Unit, Humanitas Mater Domini, Castellanza, Italy
| | - Mario Bianchetti
- Gastrointestinal Endoscopy Unit, Humanitas Mater Domini, Castellanza, Italy
| | - Alessandro Repici
- Department of Biomedical Sciences, Humanitas University, Rozzano, Milan, Italy.,Endoscopy Unit, Humanitas Clinical and Research Center IRCCS, Rozzano, Milan, Italy
| | - Benedetto Mangiavillano
- Gastrointestinal Endoscopy Unit, Humanitas Mater Domini, Castellanza, Italy.,Department of Biomedical Sciences, Humanitas University, Rozzano, Milan, Italy
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8
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Ospina-Pérez CG, Álvarez-Acuña AM, López-Álvarez LM, Ospina-Pérez RM, Lozada-Martínez ID, Rahman S. Broken beer bottle as a cause of sigmoid perforation: A summary of causes and predictors in the management of traumatic and non-traumatic colorectal perforation. Int J Surg Case Rep 2021; 85:106261. [PMID: 34388896 PMCID: PMC8353462 DOI: 10.1016/j.ijscr.2021.106261] [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: 07/02/2021] [Revised: 07/31/2021] [Accepted: 08/01/2021] [Indexed: 02/08/2023] Open
Abstract
INTRODUCTION AND IMPORTANCE The presence of foreign bodies at the colorectal level and associated complications is a problem that has become increasingly common in emergency departments. This condition carries high health costs, in addition to having high morbidity and mortality rates, due to the large number of complications such as perforation. CASE PRESENTATION 46-year-old male patient, who came to the emergency department of a low-level hospital with a clinical picture of approximately one day of evolution consisting of the violent introduction of a foreign body (bottle) at the anorectal level secondary to aggression in a fight, with subsequent endoluminal rupture. CLINICAL DISCUSSION The most recent evidence indicates that the incidence of perforation as a complication of colorectal foreign body introduction is low. However, the presence of profuse bleeding, advanced age, presence of comorbidities and sepsis are predictors of poor prognosis in these cases. In general, perforation secondary to non-traumatic causes is more frequent, being predominantly due to colorectal cancer, ischemia, diverticulitis, inflammatory bowel disease, inadequate use of enema, iatrogenic endoscopy or anorectal manometry or fecal impaction. The presence of unfavorable factors prolongs hospital stay, the risk of reoperation, perianal infection, peritonitis, sepsis and wound infection, generating mortality rates of up to 38%. CONCLUSION Colorectal perforation is more frequent in non-traumatic situations and carries health costs and risk of mortality. Its management depends on hospital aspects, clinical context of the patient and training of health personnel. However, most of the outcomes are favorable.
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Affiliation(s)
| | - Ana Milena Álvarez-Acuña
- Department of Medicine, Universidad Industrial de Santander, Cl 9 # Cra 27, Bucaramanga, Colombia
| | - Lina María López-Álvarez
- Department of Medicine, Universidad Industrial de Santander, Cl 9 # Cra 27, Bucaramanga, Colombia
| | - Rosa María Ospina-Pérez
- School of Medicine, Fundación Universitaria San Martín, Cl 75 Sur #No 34-50, Sabaneta, Colombia
| | - Ivan David Lozada-Martínez
- Medical and Surgical Research Center, School of Medicine, University of Cartagena, Cra. 50 #24-120, Cartagena, Colombia
| | - Sabrina Rahman
- Department of Public Health, Independent University-Bangladesh, Dhaka, Bangladesh,Corresponding author.
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Saeed Bamashmos A, Heshmetzadeh Behzadi A, Elfatairy K, Megahed A, Kochar P, Hegde R. Foreign bodies of body orifices: A pictorial review. Clin Imaging 2021; 80:180-189. [PMID: 34333353 DOI: 10.1016/j.clinimag.2021.07.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 06/21/2021] [Accepted: 07/07/2021] [Indexed: 12/19/2022]
Abstract
INTRODUCTION Ingestion, inhalation, and insertion of foreign bodies (FB) are commonly encountered problems in the emergency departments (ED). Radiologists pay a key role in their diagnosis and management. Selecting an appropriate imaging modality is important depending on the route of entry and reported type of FB. Diagnosing FB is time sensitive and requires radiologists to be astute and familiar with varied imaging appearances of FB. In this article, we review imaging features of most common FB seen in clinical practice and their complications. TEACHING POINTS SUMMARY: FB in body orifices are frequently seen in the ED. Imaging plays a pivotal role in the management in majority of the cases. In this article, we present several cases of commonly encountered FB.
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Affiliation(s)
- Anas Saeed Bamashmos
- Department of Radiology, Bridgeport Hospital, Yale Newhaven Health, CT, United States.
| | | | - Kareem Elfatairy
- Department of Radiology, Bridgeport Hospital, Yale Newhaven Health, CT, United States
| | - Ayah Megahed
- Department of Radiology, Bridgeport Hospital, Yale Newhaven Health, CT, United States
| | - Puneet Kochar
- Penn State Hershey Milton S Hershey Medical Center, Hershey, PA, United States
| | - Rahul Hegde
- Department of Radiology, Bridgeport Hospital, Yale Newhaven Health, CT, United States
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10
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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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11
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Pfählungsverletzungen und rektale Fremdkörper. Notf Rett Med 2019. [DOI: 10.1007/s10049-019-0614-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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12
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Miranda EP, Taniguchi H, Cao DL, Hald GM, Jannini EA, Mulhall JP. Application of Sex Aids in Men With Sexual Dysfunction: A Review. J Sex Med 2019; 16:767-780. [DOI: 10.1016/j.jsxm.2019.03.265] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 03/17/2019] [Accepted: 03/20/2019] [Indexed: 01/14/2023]
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13
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Popa F, Grigoroiu M, Georgescu ME. Intrarectal Foreign Body Detected at CT Scanner Investigating an Abdominal Syndrome. Case Rep Surg 2019; 2019:9134735. [PMID: 30881723 PMCID: PMC6387721 DOI: 10.1155/2019/9134735] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2018] [Accepted: 01/15/2019] [Indexed: 11/18/2022] Open
Abstract
The field of general surgery offers many different pathologies, cases, and situations for which the general surgeons should be competent in diagnosis as well as treatment and management, including operative intervention. Most situations are complicated by delayed admission to the hospital due to the embarrassment of patient and inability to obtain satisfactory anamnesis. This article reviews the use of computed tomography as a problem-solving tool in the identification, localization, and presurgical planning for extracting the rectal foreign object.
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Affiliation(s)
- Florina Popa
- Department of General Surgery, University of Medicine and Pharmacy “Iuliu Hatieganu”, Cluj-Napoca, Romania
| | - Madalina Grigoroiu
- Department of Morphological and Functional Sciences, “Dunarea de Jos” University of Galati, Faculty of Medicine and Pharmacy, Galati, Romania
| | - Monica Elia Georgescu
- Department of Morphological and Functional Sciences, “Dunarea de Jos” University of Galati, Faculty of Medicine and Pharmacy, Galati, Romania
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14
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Ikram S, Singh S, Kallam R, Dabra A. A play that went wrong: Unique presentation of bowel perforation from an unusually large per-rectal foreign body. BMJ Case Rep 2017; 2017:bcr-2017-222959. [PMID: 29237669 DOI: 10.1136/bcr-2017-222959] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Colorectal foreign bodies (FBs) are not unheard of in the province of surgery. They are commonly seen in men ranging from 20 to 90 years of age with a bimodal age distribution. A variety of objects have been described and reported in literature. Management involves a complete history and examination followed by the necessary investigations. Most of the time they can be removed at bedside with some manipulation techniques employing the use of some ingenious devices and/or endoscopy for adamant objects. But persistent FBs or those that are high in the rectum or those that present with complications will require operative management. We present a case of a 77 cm long FB inserted rectally for sexual gratification in a male patient, which caused a large bowel perforation, ending high intra-abdominally at the level of the spleen and diaphragm after traversing the entire abdominal cavity and requiring a laparotomy for removal.
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Affiliation(s)
- Saad Ikram
- General Surgery, Northern Lincolnshire and Goole Hospitals NHS Foundation Trust, Scunthorpe, UK
| | - Shailendra Singh
- General Surgery, Northern Lincolnshire and Goole Hospitals NHS Foundation Trust, Scunthorpe, UK
| | - Ramana Kallam
- Colorectal Surgery, Northern Lincolnshire and Goole Hospitals NHS Foundation Trust, Scunthorpe, UK
| | - Ajay Dabra
- Department of Radiology, Northern Lincolnshire and Goole Hospitals NHS Foundation Trust, Scunthorpe, UK
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15
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Kokemohr P, Haeder L, Frömling FJ, Landwehr P, Jähne J. Surgical management of rectal foreign bodies: a 10-year single-center experience. Innov Surg Sci 2017; 2:89-95. [PMID: 31579741 PMCID: PMC6754005 DOI: 10.1515/iss-2017-0021] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2017] [Accepted: 04/19/2017] [Indexed: 12/13/2022] Open
Abstract
Background Patients with a rectal foreign body (RFB) are still a rare entity in general surgery departments but with an increasing incidence over the last years. This case is sometimes difficult to treat, and due to a lack of standardized treatment options, the aim of the study was to present our clinical experiences with the diagnostic and therapeutic approach to RFBs and a review of the currently available literature. Materials and methods Data were collected retrospectively from the patient’s records of 20 patients who were treated due to an RFB between 2006 and 2016. Patient’s demographics, circumstances of insertion, inserted objects, clinical presentation, laboratory and imaging results, as well as surgical treatment and duration of hospital stay were analyzed. Additionally, a review of the literature was performed with the search items “rectal foreign body” and “surgical therapy”. Because many publications were just case reports, we did not perform a meta-analysis or a systematic review. Results Twenty-two cases in 20 patients (80% male) presented to the emergency room. The mean age was 38.5±13.7 years. In 68.2% of the cases, the cause of RFB was due to sexual preferences. The following objects were inserted: six dildos, three vibrators, two bottles, one glass, one deodorant, one apple, one fever thermometer, multiple glass fragments and razor blades in one patient and six unknown objects. For 18 RFBs, manual peranal removal without anesthesia was possible in the emergency room, but two patients required intravenous analgesia. Two patients were transferred to the operating room and the foreign body was removed via the anus under general anesthesia. Open surgery with a laparotomy was necessary for two complicated cases. One patient was in need of surgery due to a vacuum generated by the RFB, whereas the second patient suffered from a sigmoid perforation. In all cases, there was no morbidity or mortality. Conclusion In most cases, the removal of an RFB can be performed peranally in the emergency room without further complications, therefore representing the therapy of choice for RFB. Only in cases with perforation, acute abdomen, or failed peranal approaches, surgery is indicated to remove the foreign body.
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Affiliation(s)
- Pia Kokemohr
- Clinic for General and Digestive Surgery, Center for Endocrine, Oncologic and Metabolic Surgery, DIAKOVERE Henriettenstift, Marienstraße 72-90, D-30171 Hannover, Germany
| | - Lars Haeder
- Clinic for General and Digestive Surgery, Center for Endocrine, Oncologic and Metabolic Surgery, DIAKOVERE Henriettenstift, Marienstraße 72-90, D-30171 Hannover, Germany
| | - Fabian Joachim Frömling
- Klinik für Hämatologie, Hämostaseologie, Onkologie und Stammzelltransplantation, Medizinische Hochschule Hannover, Hannover, Germany
| | - Peter Landwehr
- Klinik für Diagnostische und Interventionelle Radiologie, Hannover, Germany
| | - Joachim Jähne
- Clinic for General and Digestive Surgery, Center for Endocrine, Oncologic and Metabolic Surgery, DIAKOVERE Henriettenstift, Marienstraße 72-90, D-30171 Hannover, Germany
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Anal Pain and Constipation – Beyond the Obvious. GE PORTUGUESE JOURNAL OF GASTROENTEROLOGY 2015; 22:226-227. [PMID: 28868412 PMCID: PMC5579987 DOI: 10.1016/j.jpge.2015.03.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2015] [Accepted: 03/30/2015] [Indexed: 11/23/2022]
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Unusual Retained Rectal Foreign Body. GE-PORTUGUESE JOURNAL OF GASTROENTEROLOGY 2015; 22:280-282. [PMID: 28868420 PMCID: PMC5580006 DOI: 10.1016/j.jpge.2015.06.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2015] [Accepted: 06/16/2015] [Indexed: 11/21/2022]
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Colorectal emergencies and related complications: a comprehensive imaging review--noninfectious and noninflammatory emergencies of colon. AJR Am J Roentgenol 2015; 203:1217-29. [PMID: 25415698 DOI: 10.2214/ajr.13.12323] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVE In this article, we illustrate imaging findings of colorectal emergencies encountered in the acute setting that are primarily noninfectious and noninflammatory in origin. Our review should enable the reader to identify and understand common colorectal emergencies and related complications in clinical practice. CONCLUSION The diagnosis of colorectal emergencies is mostly straightforward, but it can be challenging because of the overlap of presenting symptoms and imaging findings. Therefore, it is essential to clarify the cause, narrow the differential diagnosis, and identify associated complications.
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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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