Management of unusual rectal foreign body – Case report and literature review

Grossi, A; Rodriguez, Juan Eduardo Rios; Sousa, Alexia Aina de Freitas; Machado, Danielle Alcântara Barbosa; Albuquerque, Victor Vinícius Monteiro Lins de; Macedo, F.

doi:10.1016/j.ijscr.2022.107051

Cited by 3 publications

(1 citation statement)

References 15 publications

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“…Voluminous and painful unilateral satellite inguinal adenopathy is typical, which may fistulize to the skin, producing pus (brown chocolate). Diagnosis is affecting mainly males (58). The majority is related to sexual behaviour (anorectal erotism in 80%, sexual assault in 10%), but they can also result from selftreatment for anorectal disease (retained enema tips, thermometer), ingestion, accidents or drug smuggling (59,60).…”

Section: G) Haemophilus Ducreyimentioning

confidence: 99%

Secondary anal fissures: a pain in the a**

Ruymbeke¹,

Geldof²,

Looze³

et al. 2023

AGEB

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An anal fissure is a painful tear of the sensitive anoderm, distally from the dentate line. It is a prevalent disorder and impairs quality of life dramatically. Typical or primary fissures are associated with constipation and mostly located at the posterior midline. About 1% of fissures are atypical in appearance and are generally secondary in nature. These secondary fissures should arouse attention and require further exploration for underlying conditions, such as Crohn’s disease, malignancy, trauma or venereal infections. The aim of this manuscript is to provide a comprehensive review on the clinical aspects, evaluation and treatment of secondary anal fissures.

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Section: G) Haemophilus Ducreyimentioning

confidence: 99%

Secondary anal fissures: a pain in the a**

Ruymbeke¹,

Geldof²,

Looze³

et al. 2023

AGEB

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A retrospective analysis of transanal surgical management of 291 cases with rectal foreign bodies

Zhang

Han

et al. 2022

Int J Colorectal Dis

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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, classi cation 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. Speci cally, 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 selfinserted RFB group was signi cantly 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 in ammation 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 bodi...

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Nomogram construction of the difference in MEWS combined with SPO 2 for predicting the condition of patients with unplanned enter to the rescue room- A multi-centre study

Fan,

Qu,

Chu

et al. 2024

Preprint

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Purpose: Investigate the efficacy of the difference in Modified Early Warning Score (MEWS) (within admission to the Emergency rescue Room versus 1 h of admission to the emergency observation room) combined with Pulse Oxygen Saturation(SPO2)in early risk screening for unplanned transfer to the Emergency Rescue Room༈UTER༉. Methods: We collected the vital sign data of patients who are UTER in the emergency department of three hospitals and explored the predictive power of the difference in MEWS combined with the peripheral oxygen saturation (SPO2) of patients when they are UTER by constructing a binary logistic regression model and nomogram. The prediction model is evaluated by ROC, AUC, calibration curve and other indicators. Results: The optimal cut-off value for predicting the difference in MEWS is 3.5, and the maximum value of Youden index is 0.761. When patients are unplanned to enter the resuscitation room, the first measured SPO2 (P = 0.027, OR = 0.97, 95%CI: 0.94-1.00) and the difference in MEWS (P < 0.001, OR = 53.26, 95%CI: 29.51–96.11) are independent risk factors for predicting the progression of their condition. The training set predictive models AUC is 0.890 (95% CI: 0.853–0.927) and the internal and external validation sets’ predictive models AUC are 0.957 (95% CI: 0.917–0.997) and 0.934 (95%CI: 0.871–0.997), respectively. Conclusions: When a patient is UTER, the SPO2 measured for the first time and the difference in MEWS are independent risk factors for predicting the progression of their disease. The prediction model and the nomogram constructed by this can well predict the risk of disease change of the patient and improve the attention and vigilance of clinicians and nursing staff to the patient's disease.

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Management of unusual rectal foreign body – Case report and literature review

Cited by 3 publications

References 15 publications

Secondary anal fissures: a pain in the a**

Secondary anal fissures: a pain in the a**

A retrospective analysis of transanal surgical management of 291 cases with rectal foreign bodies

Nomogram construction of the difference in MEWS combined with SPO 2 for predicting the condition of patients with unplanned enter to the rescue room- A multi-centre study

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