Management of foreign bodies in the rectum

Rodríguez-Hermosa, José Ignacio; Codina-Cazador, Antoni; Ruíz, Blás Antonio Medina; Sirvent, Josep-María; Roig, José V.; Farrés, Ramón

doi:10.1111/j.1463-1318.2006.01184.x

Cited by 93 publications

(109 citation statements)

References 19 publications

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“…The diagnosis of rectal FB should be suspected when a patient presents with pelvic or perianal pain and/or rectal haemorrhage, an unconvincing story and the absence of a history of rectal instrumentation for therapeutic or diagnostic purposes. Because of potential complications, FB in the rectum should be considered a serious condition that must be treated without delay [2].…”

Section: Discussionmentioning

confidence: 99%

Severe intraperitoneal injuries due to self introduced rectal foreign body

Sandhu

Rao²

2008

Indian J Surg

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Rectal foreign body insertion is an increasingly common surgical dilemma that requires thorough history, physical examination, radiographs and inventiveness to treat. Additionally the surgeon should demonstrate a sympathetic and caring attitude. This case report highlights the successful surgical management of a rare and bizarre case of extensive intraperitoneal injuries due to a wire inserted by the patient to retrieve a rectal foreign body introduced for sexual gratifi cation. Keywords Rectal foreign bodies Case reportA 42-year-old male presented with the history of accidental introduction of a glass bottle per rectum when he allegedly slipped in the toilet and fell on a bottle lying on the ground the previous night. He also complained of severe lower abdominal pain. On general examination patient was uncomfortable and had temperature of 99.4°F, pulse rate of 110/min and blood pressure of 116/78 mm Hg. On local examination a wire was seen protruding from the anus (Fig. 1). The anal tone was lax. There was abdominal distension, generalized tenderness, guarding, rigidity and rebound tenderness signifying generalized peritonitis. These fi ndings were more marked in the lower abdomen. Systemic examination was normal. Hematological and biochemical parameters were normal except for polymorphonuclear leukocytosis. Plain abdominal radiograph showed an elongated foreign body presumably a bottle and a wire in the pelvis (Fig. 2).A very gentle attempt to dislodge the wire was unsuccessful. In view of generalized peritonitis and presence of rectal foreign bodies the patient was taken up for emergency surgery. Midline laparotomy was performed under general anesthesia. There was 500 ml of purulent/feculent material and blood in the peritoneal cavity and pelvis. A glass hair oil bottle (300 ml) was present in the rectum which was manipulated distally and delivered per anum. The wire which was in fact a straightened clothes hangar and hooked at its end had perforated the anterior wall of the intraperitoneal portion of the rectum and mesentery of the distal ileum. The hooked end of the wire was embedded in the mesentery of the ileum. The wire was straightened and removed per anum. Tears in the rectum and mesentery were repaired. Peritoneal toilet and diverting loop sigmoid colostomy was done. Appropriate parenteral antibiotics were administered.

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Section: Discussionmentioning

confidence: 99%

Severe intraperitoneal injuries due to self introduced rectal foreign body

Sandhu

Rao²

2008

Indian J Surg

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“…Laparatomi yap›lan hastalarda ise öncelikle yabanc› cisim sa¤ma yöntemiyle distal rektuma oradan da d›flar› al›nmal›, baflar›s›z olundu¤unda kolotomi ile müdahale denenmelidir. 2,4,11,12 Rektumdan yabanc› cisim ç›kar›lan tüm hastalar ifllem sonras›nda mutlaka izleme al›nmal› ve rektal ve/veya kolonik perforasyon için endoskopik olarak incelenmelidir. 13 Olgumuz genel anestezi alt›nda, tam bir kas gevflemesi sa¤land›¤›nda hastan›n zay›f olmas›n›n da yard›m›yla abdominal ve rektal yolla yap›lan bimanuael muayene ile cisim hareketlendirildi ve rektumdan d›flar› al›nd›.…”

Section: Resim 3 Rektal Yabanc› Cisimunclassified

“…Giriflimin flekli hastada peritonit varl›¤›, yabanc› cismin rektumdaki seviyesi ve baflvurulan birimin olanaklar› düflünülerek belirlenmelidir. [2][3][4][5][6] Eftaiha ve ark. 7 çal›flmalar›nda rektal yabanc› cisimleri yüksek yerleflimli ve alçak yerleflimli olarak s›n›flam›fllar ve tedavi plan›n›n buna göre belirlenmesini önermifllerdir.…”

Section: Resim 3 Rektal Yabanc› Cisimunclassified

Rectosimoid foreign body

Balta¹,

Yücel²,

Karakaş³

et al. 2011

Kolon Rektum Hast Derg

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ÖZETRektumda yabanc› cisimler genel cerrahlar›n meslek hayatlar› boyunca s›k olmasa da karfl›laflabilecekleri klinik bir durumdur. S›kl›kla homoseksüel yaklafl›mlar veya oto-erotik eylemler sonucunda meydana gelirler. Rektumda yabanc› cisim tan›s› konan hastalarda öncelikle perforasyon varl›¤› araflt›r›lmal›d›r. Perforasyon olan hastalar›n tedavisinde operatif tedavi yöntemleri ön planda iken perforasyon olmayan hastalar›n tedavisinde yatak bafl› nonoperatif ifllemlerden laparatomiye kadar varan birçok tedavi seçene¤i mevcuttur. Anahtar Kelimeler: Rektum, Yabanc› cisim, Perforasyon, EndoskopiABSTRACT Presence of foreign bodies in the rectum is not an uncommon condition for general surgeons during their careers. This clinical condition generally occurs due to homosexual habits and autoerotic actions. When foreign body is diagnosed in the rectum, probability of a perforation should be evaluated first. While operative management is forefront in the patients with perforation, there are various treatment modalities from bedside nonoperative procedures to laparotomy for the patients without perforation. In this case, the presentation of nonoperative management of a patient with a rectal foreign body in the operating room under general anesthesia is aimed.

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“…Open surgery under general anaesthesia must be reserved only for those patients with very large objects or those suffer from peritonitis due to rectal perforation or pelvic sepsis. Although the majority of patients with rectal FB require an examination under anaesthesia or even, on occasion, a laparotomy for removal, a few FB may pass spontaneously after the administration of enemas or laxatives [2]. After FB extraction, all patients must remain in observation to exclude possible rectal perforation.…”

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confidence: 99%