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Author(s): Nesemann, Samuel; Hubbard, Kimberly A.; Siddiqui, Mehdi I.; Fernandez, William G. | 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.

Transanal rectal foreign body implies that a foreign body has been inserted transanally due to sexual orientation or other reasons and cannot be removed. Such cases require emergency measures because foreign bodies often present difficulties in manual removal or endoscopic removal and may even require surgery when peritonitis due to gastrointestinal perforation occurs. We report a patient in our hospital who had a rectal foreign body inserted into the deep part of the proctosigmoid that could be removed endoscopically. A 66-year-old man visited our hospital because of an eggplant which had been inserted into his rectum by his friend and could not be removed. Since plain abdominal computed tomography showed a foreign body thought to be an eggplant in the proctosigmoid, the foreign body was captured and removed with a snare under lower gastrointestinal endoscope guidance.

Foreign body insertion in rectum is not uncommon, predominantly presenting in males [1]. Potential reasons are self-treatment for anorectal conditions, criminal assaults and most commonly for sexual purposes. Almost any object one can think of has been found in rectum [2]. Rectal foreign bodies have different presentations, depending on foreign body shape, size, sharpness and duration of time from insertion to hospital presentation. Local anorectal injury, intestinal obstruction, bowel perforation and peritonitis are all complications [3]. Attempts of removal of foreign bodies at home are almost always present, but can be hazardous, especially if sharp or pointed instruments are used. Manual extraction at the emergency department should be tried first, if it fails, more sophisticated interventions should be used, such as proctosigmoidoscopy, laparoscopy or open surgical interventions. Here we present a case of impacted plastic ball in the rectum that could not be extracted using the above-mentioned techniques. As the ball was wedged in the pelvis and downward pressure during laparotomy failed to move it into the rectum, and transanal upward pressure failed to deliver it into the abdomen. This case is reported in line with the Updating Conscnsus Surgical CAse REport (SCARE) 2020 criteria [4].

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.

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.

Highlights • A long-term retained rectal foreign body is rare, compared to other foreign bodies. • We describe a foreign body in the rectum for 5 months. • This resulted in a huge rectovesical fistula and requireing emergency laparotomy. • These rare foreign bodies could result in a large fistula or diffuse inflammation. • In these cases, we should prepare for surgical treatment of multiple pelvic organs., Introduction Most patients with foreign bodies in their rectums present to medical institutions within a few days. In this report, we describe a foreign body in the rectum in situ for 5 months that resulted in a huge rectovesical fistula 4 cm in diameter, requiring emergency laparotomy. Presentation of case A 59-year-old man, who had undergone rectal foreign body extraction via the anal canal without any complications 7 years previously, presented with abdominal pain and diarrhea. Computed tomography revealed a cup-shaped rectal foreign body and huge rectovesical fistula. We performed an emergency laparotomy. There was no contaminated ascites. The adhesion around the fistula was too stiff to be dissected. We incised the rectal wall, excised the ceramic cup-shaped foreign body, and detected a fistula approximately 4 cm in diameter. We performed sigmoid colostomy, and the incised rectal wall and the bladder wall were sutured, and the residual rectum was supposed to function as a part of the bladder. After the surgery, no severe complications occurred. The patient told us that he inserted the foreign body himself 5 months earlier, and urine had appeared in the stool in the previous month. Discussion A long-term retained rectal foreign body is very rare and could create an abnormal huge fistula between the pelvic organs because of prolonged pressure on the walls of the pelvic organs. Conclusion In patients with a long-term retained rectal foreign body, we should prepare for surgical treatment of not only the rectum but also the other pelvic organs.

Purpose Retained foreign rectal objects may require surgical removal. To estimate the magnitude of this problem, we report the incidence and treatment of retained rectal objects at a large emergency hospital, and calculate incidence rates at the national level in Sweden. Methods All local patient records during 2009–2017 with the diagnosis foreign body in anus and rectum (ICD-10 T185) were accessed and analyzed retrospectively. All Swedish in- and outpatient visits during 2005–2016 with the code T185 were accessed from the National Patient Register. Results We show an increasing incidence in rectal foreign bodies in Swedish national data. The increase was most noticeable in men, and in our local register there was an overrepresentation of sex toys leading to laparotomy and stoma. Conclusions To mitigate surgical cost and comorbidity, policies to decrease the risk of retained sex toys could be considered.

Though anorectal foreign body cases are rare, they have become increasingly frequent in recent years. Although entrapped foreign bodies are most often related to sexual behavior, they can also result from ingestion or sexual assault. The diagnosis may be made by rectal examination and metallic objects can be confirmed by plain abdominal radiographs. Transanal removal is only possible for very low-lying objects, while patients with high-lying foreign bodies usually require an operative intervention. An early decision of laparotomy should only be made after subjecting the patient to suitable investigations to determine exact location of the object, in order to avoid any inadvertent damage to the adjoining vasculature as well as anal incontinence. . We report the case of a young male who presented at surgery department of Shaheed Suhrawardy medical college hospital with severe rectal pain due to insertion of an apple into rectum by some eunuchs. It was successfully removed transanally under spinal anesthesia. Post operative period was uneventful and referred for psychiatric consultation.J Shaheed Suhrawardy Med Coll, June 2017, Vol.9(1); 35-37

Background Rectal foreign bodies are commonly encountered in the emergency department (ED). Three techniques are well described in literature, including using a Foley catheter, “scooping” the object out, or grasping the object directly with ring forceps. We present a novel extraction method for an inflatable foreign body. Case Report A 27-year-old man presented to the ED 13 h after inserting a rubber inflatable child's ball into his rectum. After well-described extraction techniques failed to remove the ball, an 18-gauge needle at the end of a syringe was inserted into the rectum to puncture the ball and partially deflate it. The ball was then able to be removed easily. Why Should an Emergency Physician Be Aware of This? Although recent published literature has pushed for early consultation of surgical specialties in lieu of emergency physician bedside extraction, this case report highlights the ability of emergency physicians to modify known extraction techniques to safely remove rectal foreign bodies in well-appearing patients at the bedside using appropriate analgesia, positioning, and readily available equipment.

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.

Irretrievable rectal foreign bodies can cause significant distress and generally require emergency medical attention. While smaller objects can often be removed trans-anally, larger objects typically require more invasive intervention. Here, we report the case of a 57-year-old man who had previously presented to the emergency department with a baseball lodged in the rectosigmoid that required a laparotomy. One year later, he represented with a significantly larger object also affixed in the rectosigmoid. Exploratory laparotomy revealed an edematous, inflamed bowel with extensive adhesions from the pervious surgery. Given the degree of tissue damage and large size of the object, the decision was made to perform a Hartmann’s procedure. The object, an 11 × 10 cm rubber chew toy, was successfully removed and the patient was referred to the appropriate mental health professionals during follow-up.

Rectal foreign bodies (RFBs) are an unusual emergency presentation readily confirmed via clinical examination and imaging, which must be quickly removed due to the risk of rectal wall tissue damage leading to perforation and subsequent peritonitis. Several non-operative methods are described in the literature to retrieve RFBs, however removal can be especially difficult if they not easily graspable, for example a ball-like object. We present the case of a spherical RFB successfully extracted using a vacuum-assisted delivery device.

The management of trauma to the rectum and anus has a complicated past rooted in military and battlefield experiences. Rectal trauma management varies widely based on the anatomic location and degree of the injury. Intraperitoneal rectal injuries are generally treated much like left colon injuries. Numerous factors play into the complicated operative algorithm for extraperitoneal rectal injuries. This chapter discusses the literature, reasoning, and scenarios for proximal fecal diversion, presacral drain placement, primary rectal repair, and the use of distal rectal washout. Rectal foreign body extraction is explained. The evaluation and acute management of traumatic anal sphincter injury, including a brief overview of outpatient incontinence options, is reviewed.

Introducción: El cuerpo extraño en el recto-sigma es una patología poco frecuente con múltiples causas, siendo variado en su forma, tamaño y naturaleza; en la gran mayoría esta se resuelve por una salida espontánea y su correcta vigilancia, pero a la vez existen varias complicaciones tales como obstrucción intestinal, infección y perforación lo cual nos llevará a tener un tratamiento quirúrgico de urgencia. La vía rectal es la causa principal de hallazgos de cuerpos extraños seguidos de la vía oral en segundo lugar y en tercer lugar con baja frecuencia la migración de órganos vecinos por varias causas como presencia de fístulas. De tal manera que pocos pacientes admiten la introducción de objetos por vía anal, el profesional médico debe sospechar si hay la presencia de dolor pélvico, abdominal bajo y dolor perineal; además de la presencia de proctorragia, y a la palpación que pueda o no existir presencia de masa abdominal, todo esto corroborando antecedentes en la historia clínica que se puede mostrar incongruente e inespecífica y el paciente sea poco colaborador. Objetivo: Describir el abordaje clínico quirúrgico de un paciente con perforación sigmoidea por cuerpo extraño. Material y métodos: Estudio descriptivo retrospectivo, presentación de caso clínico de perforación sigmoidea por cuerpo extraño. Resultados: Se describe el caso clínico de un paciente ingresado en la casa de salud, por presencia de dolor abdominal acompañado de una masa abdominal a la palpación, se diagnostica la presencia de un cuerpo extraño rectal y se procede a realizar una cirugía de emergencia, evidenciando en el acto quirúrgico presencia de cuerpo extraño (botella plástica) con perforación sigmiodea con extracción por sitio de la perforación. Conclusiones: Los cuerpos extraños tras anales son relativamente frecuentes, son susceptibles a sufrir alguna complicación lo que nos amerita a tomar una resolución quirúrgica de emergencia. Una vez que se haya diagnosticado la patología el manejo siempre es la extracción del cuerpo extraño, con el uso de las diferentes técnicas que ameriten el cuadro y ayude a la extracción del mismo y mejore la morbilidad del paciente.

Highlights • Rectal impalement injuries are infrequently encountered in surgeons’ practice. They pose a diagnostic challenge to surgeons and put them in demanding circumstances for successful extraction. • High index of suspicion of perforations should be there in all rectal foreign bodies. Iatrogenic bladder injuries give excellent results when repair suitably. • Prompt diagnosis and immediate intervention to remove the foreign bodies are quintessential in all rectal foreign bodies with evidence of perforation., Introduction and importance Rectal perforations due to foreign body impalement are infrequently encountered in practice. Accidental or intentional foreign body insertions pose a diagnostic challenge to surgeons and put them in demanding circumstances for successful extraction. Case presentation We report a case of a 60-year-old male with alleged history of accidental foreign body insertion into the rectum. Radiographs showed a linear metallic foreign body with crooked end. Computed Tomography (CT) with rectal contrast revealed contrast extravasation indicating anterior wall perforation of upper rectum. Patient was taken urgently for exploration and foreign body removal. Intra-operatively, bladder was injured inadvertently. Primary repair of enterotomy and loop sigmoid-ostomy was done besides bladder repair. Patient tested positive for COVID-19. Patient was observed in critical care unit for two days. Post-operative period was unremarkable apart from midline abdominal wound gape for which secondary closure was done. Patient was discharged with urinary catheter in-situ. Patient followed-up with a normal cystourethrogram and a well-functioning stoma. Stoma closure after two months was uneventful. Clinical discussion A thorough history and clinical examination is required and one should raise a high index of suspicion of perforation in patients with rectal foreign bodies, which should be managed appropriately and promptly to prevent sepsis and multi-organ dysfunction. Inadvertent bladder injuries are common with lower-midline incisions. However, give good results when repaired suitably. Conclusion The rationale behind this report is to explicate the complexity and hurdles in the surgical management of rectal foreign bodies causing impalement injury.

Rectal foreign bodies represent a unique and challenging field of surgical management which includes a careful history, physical examination and a high index of suspicion for complications. Foreign bodies are rarely seen in lower GI or rectum, inserted either accidently or for sexual satisfaction or to inflict harm. We have 3 case scenarios of unusual foreign body in rectum with varied clinical presentation, findings and three different methods of management/extraction done in our Institution. Patients present with common complaints of rectal or abdominal pain, constipation or obstipation, bright red blood per rectum, or incontinence. Initial step is to assess for peritonitis which is suggestive a perforation with intraperitoneal contamination and requires emergency exploratory. Erect Xray abdomen can reveal the presence of free air and the location of the object relative to the pelvic floor. A careful digital rectal examination is the most informative component of the evaluation process. Impacted foreign bodies may result in complications like intestinal obstruction, perforation of gut and peritonitis. Rectal foreign body is a diagnostic and management dilemma due to the delayed presentation owing to associated social stigma. Patients require a detailed examination and radiographic evaluation with resuscitation. Surgical intervention should be planned based on hemodynamic stability and presence/absence of perforation. Patient has to be referred to the psychiatrist for his perversion disorder, which is also mandatory for preventing recurrences.

The rate of colorectal foreign bodies is increasing. Endoscopists must be creative in order to remove the foreign objects safely in the most minimally invasive manner as these objects could vary greatly in size and shape. We present a case of the novel use of an esophageal overtube to aid in the removal of a difficult-to-remove Tide-To-Go cap.

A 67-year-old man presented with a 2-month history of pain in his right buttock and lower limb. MRI depicted right L5/S1 lateral recess stenosis requiring surgical treatment; however, preoperative CT showed an approximately 7 cm long, thin, rod-shaped structure in the rectum, which was ultimately determined to be an accidentally ingested toothpick. It was removed surgically 6 days after diagnosis, because right leg pain worsened rapidly. The pain disappeared thereafter, and the symptoms have not recurred since. The pain might have been localised to the right buttock and posterior thigh in the early stages because the fine tip of the toothpick was positioned to the right of the anterior ramus of the S2 spinal nerve. Although sacral plexus disorder caused by a rectal foreign body is extremely rare, physicians should be mindful to avoid misdiagnosis.

Background: Rectal foreign body is uncommon in emergency usually presenting after failure to remove the object manually or with other complications.Case: Twenty two years male in emergency department presented with rectal leeding following a manual attempt to remove drug ampoules from rectum.Conclusion: In an unexplained rectal bleed, foreign bodies could be a pitfall.Health Renaissance 2015;13(3): 185-187

A 39-year-old man died of multi-organ failure complicating mixed drug toxicity that included methadone, oxazepam, oxycodone and nitrazepam. His past medical history involved alcohol and poly-substance abuse with chronic self-harm and suicidal ideation. There had been multiple hospital admissions for drug overdoses. At autopsy the most unusual finding was of two packages of 10 tablets each, wrapped in thin plastic film within the rectum. The insertion of drugs into body orifices and cavities has been termed body pushing to distinguish it from body packing where illicit drugs are wrapped and swallowed for transport and smuggling, and body stuffing where small amounts of loosely wrapped or unwrapped drugs are swallowed to conceal evidence from police. This case demonstrates that body pushing may not always involve illicit drugs or attempted concealment from police or customs officials. It appears that the drugs had been hidden to ensure an additional supply during the time of residence in hospital. The extent to which body pushing is currently being used by patients to smuggle drugs into secure medical facilities is yet to be determined.

Foreign bodies in the pediatric population are frequently seen in the nasal, aural and oral cavities, but are much less commonly reported in the rectum. While these cases are rarely reported in the literature, 8359 rectal foreign bodies were documented in the National Electronic Injury Surveillance System in patients 0–25 years old between 2008 and 2017, with a significant up trend in reported frequency annually [1]. Rectal foreign bodies may result in grave complications such as bleeding, perforation, abscess, sepsis or death [2]. Despite its growing incidence and potentially morbid outcomes, there are few documented case reports in the existing literature and there is no established management guideline for evaluation and management of rectal foreign bodies in the pediatric population. In this case report and review of the literature, we present an unusual case of a radiolucent foreign object in the rectum of a 10 year old child, only visualized with 3D reconstruction on CT scan, and the steps taken towards its removal. Keywords: Rectal foreign body, Sharp rectal objects, Child abuse, Abdominal pain, Proctalgia, Hematochezia

Background: Historically, the acceptance of anorectal sexual practices has varied throughout different civilizations. While he was condemned in biblical times, anal intercourse was often practiced by the Greek and Roman civilizations. Due to the current changes in sexual behavior, the surgeon is currently facing new problems in the diagnosis and treatment of rare rectal lesions. Clinical case: Male 37 years-old, married who presents to the emergency room complaining of pain in posterior anorectal area to the introduction of a foreign body, the patient reports attempted manual removal at home by maneuvers Valsalva unsuccessfully. Patient with stable vital signs and physical examination, normal chest and abdomen and rectal exam glass object is palpated proximal end with metal, plain abdominal radiography is requested where is evident the intraanal object. Laboratory test normal: Manual removal is attempted in emergencies without success due to the caused pain and decided to pass to the operating room where under spinal block and position in Sevillian razor a curve clamp rings is used and removal of the foreign body is achieved without difficulty. Discussion: Retained rectal foreign body is not an uncommon condition, but reliable epidemiological data are not available. The aim of the clinical evaluation is to identify the type, number, size, shape and location of the foreign body. Removal of retained rectal foreign bodies requires experience, with particular attention to different methods of extracting various objects. It is mandatory to perform a proctosigmoidoscopy after anorectal foreign body removal to exclude bowel injury and ensure that the patient has not inserted more than one foreign body. Patients with mucosal abrasion, tears and edema are to be admitted for a period of observation

A 42‐year‐old man presented to the emergency department with a 75‐mm long piece of polyvinyl chloride (PVC) pipe of 70 mm diameter lodged inside his rectum. He reported that 2 days earlier, he fell from a ladder at home and it had accidentally lodged there. He delayed his presentation because he thought it would pass spontaneously. He reported moderate amounts of rectal bleeding since that event. He denied any previous similar episodes. He had no medial or surgical history, took no regular medications, and smoked 15 cigarettes a day.

Rectal foreign bodies are a common presenting complaint in the emergency department. Anal eroticism is the major reason for the majority of cases of rectal foreign bodies. A high index of suspicion is required to accurately diagnose a rectal foreign body as patients are often embarrassed about their condition and may not present in a timely fashion to be evaluated or volunteer their history. Extraction techniques include transanal, endoscopic, and laparotomy with repair of complications. Here, we present the case of successful transanal manual removal of a retained dumbbell in the rectum of a middle-aged man.

Transanal minimally invasive surgery (TAMIS) was first described in 2010 as a crossover between single-incision laparoscopic surgery and transanal endoscopic microsurgery (TEM) to allow access to the proximal and mid-rectum for resection of benign and early-stage malignant rectal lesions. The TAMIS technique can also be used for noncurative intent surgery of more advanced lesions in patients who are not candidates for radical surgery. Proper workup and staging should be done before surgical decision-making. In addition to the TAMIS port, instrumentation and set up include readily available equipment found in most operating suites. TAMIS has proven its usefulness in a wide range of applications outside of local excision, including repair of rectourethral fistula, removal of rectal foreign body, control of rectal hemorrhage, and as an adjunct in total mesorectal excision for rectal cancer. TAMIS is an easily accessible, technically feasible, and cost-effective alternative to TEM.

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.

Background/Aims: Almost all previous studies related to rectal foreign bodies were based on bizarre and striking cases, resulting in a reporting bias. Our aim was to clarify the clinico-epidemiological findings of rectal foreign body (RFB) in a general population. Methods: Using a national administrative database in Japan, we identified patients who underwent in-hospital treatment for rectal foreign bodies from 1 July 2007 to 31 March 2013. Results: A total of 648 RFB patients with 666 presentations were identified during the study period. The number of male patients was 526 (81.1%). The incidence of a RFB was most frequently seen in males who were in their 60s and in females who were in their 80s. The overall in-hospital mortality was 1.2%. Compared with males, females had a significantly higher proportion of in-hospital death (0.4 vs. 4.8%, p = 0.001), perforation and peritonitis (5.2 vs. 12.8%, p = 0.004), and sepsis (1.1 vs. 4.0%, p = 0.04). Conclusion: This study showed the clinico-epidemiological findings of rectal foreign bodies in a general population, and established that there was a low mortality rate. It was also found that females were significantly more likely to have a severe outcome following a RFB than males.

Foreign body (FB) within the rectum occurs infrequently and its management is challenging for the emergency physicians due to variation in type of objects, host anatomy, time of insertion, and amount of local contamination. Usually, the presentation is late after multiple unsuccessful attempts for the removal of the FB by patients themselves at home. We report a 50-year-old male patient presented to the emergency department with an FB in the rectum (iron rod) introduced as sexual perversion. The patient was managed conservatively and transanal retrieval of FB was carried out successfully. We reviewed the management options from the currently available literature.

We present a case report of an unusual large foreign body in Rectum. Our patient presented with signs of intestinal obstruction following insertion of plastic oil bottle in the rectum for breaking fecal impaction. Patient was then evaluated and transanal retrieval of foreign body was carried out successfully.