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A man in his 60 s, who had experienced sustained abdominal pain intermittently for three years, lost consciousness and was transferred to an emergency hospital, where he was pronounced dead. In the forensic autopsy, a giant bladder stone measuring 6.5 × 6.0 × 4.0 cm was found adhering to an aluminum eyeliner that penetrated the anterior wall of his rectum. This might have induced pyelonephritis in the left kidney, resulting in sepsis. The deceased may have inserted the eyeliner for sexual stimulation. However, the eyeliner did not injure the peritoneum and no peritonitis occurred, which probably prevented acute sepsis immediately after insertion. The exact time of penetration was undetermined; however, the rectal foreign body may have been retained for three years. This case suggests that sexual activity should be considered a possible manner of death, even if it took place several years previously.

Abstract A 67‐year‐old woman was referred to our hospital for further evaluation of a positive fecal occult blood test. Colonoscopy revealed an elevated rectal lesion (10 mm in size) with a central depression. A rod‐like object was noted in the center of the lesion. Magnifying endoscopy with narrow‐band imaging showed obscure surface structures and dilated vessels. Magnifying endoscopy with crystal violet staining showed that the pit pattern had disappeared. These endoscopic findings suggested that the lesion was comprised of granulation tissue. A detailed medical history revealed that she had undergone a total hysterectomy with mesh placement for bladder prolapse. We reasoned that the mesh used during pelvic surgery might have penetrated the rectum. She underwent subsequent surgery to remove the mesh. Although most foreign bodies in the rectum are swallowed or self‐inserted, pelvic surgery is another source of foreign bodies in the rectum.

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.

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• Rectal foreign bodies pose a significant clinical challenge and can lead to serious complications if not managed promptly. • This article presents a clinical case of a 62-year-old man with an unusual rectal foreign body in the form of fluid-containing spheres. It highlights a minimally invasive approach for removal. • Endoscopy combined with surgical instruments successfully removed the foreign body, avoiding the need for surgical incision. • The patient experienced no active bleeding or perforation, highlighting the safety and efficacy of this approach. • In cases of solid, non-hydrocystic rectal foreign bodies, drainage and removal through the anus should be considered as the primary procedure. • This report provides valuable insights for gastroenterologists and clinicians dealing with rectal foreign body cases. [ABSTRACT FROM AUTHOR]

Introduction: Rectal foreign bodies (FB), as a cause of surgical emergency are on the rise. The management is usually uneventful but delays in presentation are associated with complications and morbidity. Psychiatric illnesses account for a vast majority of FB insertion cases which is usually overlooked., Case Presentation: 56 year male with alleged history of insertion of a discarded bottle of insecticide into his rectum 6 weeks ago. He presented late, in sepsis due to lack of family support and social taboo, in sepsis. The foreign body was extracted by trans-anal approach with no evidence of bowel injury on laparoscopy. Psychiatry consultation revealed alcohol-induced psychosis which was managed., Clinical Discussion: Insertion of foreign bodies voluntarily for sexual gratification is common, apart from some accidental cases. There is delay in seeking medical attention, complicated by many social factors. Multiple approaches to management are in practice. Psychiatric component is linked in part to the primary act, delayed presentation and recurrence., Conclusion: Foreign body insertion into anatomical orifices is on the rise. Management can be complicated by body of interest, patient and social factors. Psychiatric history, evaluation and corresponding management is a must for all cases. Social awareness can help reduce incidence and the delay in seeking medical care., Competing Interests: Declaration of competing interest There was no conflict of interest., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Although becoming more common, a foreign body in the rectum remains a challenging presentation. This is due to both a lack of clarity of treatment algorithms and established clinical guideline pathways and trying to avoid invasive methods to improve patient outcomes. We present a case where a foreign body was inserted into the rectum as a form of self-harm requiring emergency theater in the form of a sigmoid colectomy., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Patel et al.)

Résumé: La prise en charge des corps étrangers du tractus digestif est un motif fréquent de réalisation d'endoscopies en urgence. Concernant le système digestif haut, il s'agit d'aliments et d'objets ingérés accidentellement ou non. Les recommandations sont claires et bien établies. Concernant l'intestin grêle, si une intervention se révèle nécessaire, elle sera le plus souvent chirurgicale à l'occasion d'une complication. Une entéroscopie peut être proposée pour l'impaction de vidéo-capsule. La prise en charge des corps étrangers intrarectaux est moins bien codifiée mais, en l'absence de complication perforative, elle repose sur une stratégie ascendante allant de la tentative d'extraction digitale à la chirurgie avec étape endoscopique intermédiaire. Lorsque les procédures d'extraction endoscopique de corps étrangers du tractus digestif sont réalisées de façon adaptée, les taux de succès en sont élevés et les complications rares permettant le plus souvent la sortie rapide du patient. The management of foreign bodies of the digestive tract is a common reason for performing emergency endoscopies. Regarding the upper digestive system, food and objects accidentally swallowed or not might be found. The recommendations are clear and well established. Regarding the small intestine, if an intervention is necessary, it is most often a surgical one due to a complication. An enteroscopy may be proposed for video-capsule impaction. The management of intra-rectal foreign bodies is less well codified but, in the absence of perforative complications, is based on a bottom-up strategy ranging from digital extraction attempt to surgery with intermediate endoscopic stage. When endoscopic extraction procedures for foreign bodies from the digestive tract are performed appropriately, the success rates are high and complications rare most often allow the patient to be discharged quickly. [ABSTRACT FROM AUTHOR]

Occurrence of retained rectal foreign bodies with bowel perforation resulting from auto-eroticism is rare among males in Africa. Embarrassment attached to this condition may delay or derail acquisition of information and management. A 30-year-old male presented with abdominal pain and constipation for 3 days. Abdominal X-rays revealed free air-stripes under both hemidiaphragms and in the peripherals, a 25cm x 5.9cm lucent foreign body on the left side with proximal tapering. There was no evidence of intestinal obstruction. This was consistent with bowel perforation secondary to foreign body introduction. Exploratory laparotomy was performed, a plastic bottle of 250mls was removed from the colon. Transverse repair of a 10cm laceration extending from the rectum to the sigmoid was done and a colostomy placed. A high index of suspicion, a systematic approach and a lower threshold for imaging studies were key to successful management and favorable outcomes of this patient. [ABSTRACT FROM AUTHOR]

Removal of rectosigmoid retained foreign bodies (RFB) may require laparoscopy and often laparotomy. Proctoscopic extraction from the distal sigmoid colon and proximal rectum can be technically difficult. Using a transanal minimally invasive surgery (TAMIS) approach, RFBs can be safely removed, avoiding an abdominal operation with associated morbidity. Patients without clinical findings concerning for acute colonic perforation undergo bedside digital rectal examination and proctoscopic attempt at removal of RFB. If unsuccessful, patients undergo rectal examination under anesthesia with proctoscopy and attempted RFB removal. If the RFB cannot be easily removed, a TAMIS port is inserted into the anal canal and pneumorectum is established. A laparoscopic camera and instruments are then used to facilitate removal of the RFB. To date, TAMIS was successful in all 10 patients with RFB requiring an operation. All patients tolerated the procedure well and were discharged to home from the postoperative recovery room. Unfortunately, none of the patients presented for follow-up visits, but there were no known complications. This technique can be considered prior to laparotomy for patients with RFBs after failed digital examination with proctoscopy. [ABSTRACT FROM AUTHOR]

Purpose: Rectal foreign bodies can pose a unique problem to the acute care surgeon or emergency room physician. Little data exists on the patient with such a diagnosis, outside of case reports, and institutional cohorts. This study describes demographics and outcomes for this patient population. Methods: An analysis of the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database (2015 to 2018) was performed, capturing patients with a postoperative diagnosis of foreign body of the anus or rectum. Patients were stratified into two groups: those who underwent removal under anesthesia (EUA) and those who required surgical removal. Baseline demographics and outcomes were compared and described. Results: A total of 109 patients were included in the study. The average age was 49.29 ± 14.63 years. The majority of the population was male (92.66%) and white (78.90%). Demographics and preoperative variables were clinically similar between patients receiving an EUA or an operation. Length of stay was longer in patients receiving an operation (4.84 ± 3.27 versus 1.39 ± 3.20 days in those receiving an EUA, p < 0.0001). About 97.24% of the population discharged to their home residence. Conclusions: This study describes a population of patients admitted for retained foreign body of the rectum, in a population larger than that can be described in a typical institutional review. EUA can be a safe approach to foreign body removal, with laparotomy carrying the typical risks of surgery. This population requires further study to identify the mechanisms and risk factors for alimentary tract injury to reduce operative interventions and improve outcomes. [ABSTRACT FROM AUTHOR]

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 ingestion is not uncommon in pediatric age group. Foreign bodies including coin retention/impaction at the colorectal regions are less frequently reported in children and extremely rare in the operated cases of anorectal malformation (ARM). The present case is a 5.8-year-old boy who had retention of ingested foreign body (coin) in his rectum for 4 months. His history revealed that he was a case of high ARM which was managed with three-staged procedures. His clinical examination and radiological investigations revealed an anal stricture and a foreign body (coin) in his rectum. He was managed well with anal dilatation and removal of coin under general anesthesia. The intention for presenting the case is its rarity.

A foreign body in the rectum is not an uncommon encounter in current medical practice. In most cases, rectal foreign bodies are a result of sexual eroticism, sexual abuse, assault, or rarely, accidental involuntary insertion. It poses diagnostic difficulties and management challenges among medical professionals. The diagnostic approach usually involves careful history and physical and radiological examination. Here, we present the case of a 22-year-old man with a retained rectal foreign body for a duration of 3 hours. He presented with impacted foreign body per rectum, non-specific abdominal pain, abdominal mass, and non-passage of stool and flatus. Successful removal of the rectal foreign body was done manually under local anesthesia in the lithotomy position in the operation theatre. [ABSTRACT FROM AUTHOR]

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.

Introduction: The rectal foreing body (RFB) is a problem which involves a difficult management for surgeons. Anal via is the most frequent entrance area, followed by the oral via. Clinical suspicion is fundamental for diagnosis and it is possible to support it using imaging. Treatment considers extraction through transanal or frontal via. Aim: To describe and present the treatment of patients with rectal foreing body in the Urgency Service of El Pino Hospital during years 2011 to 2016. Materials and Method: Case studies. Clinical records revision of patients with rectal foreing body in the Urgency Service of El Pino Hospital considering a 5-year period. Patients are identified as those treated in the box and in a surgical pavilion. Patients were classified according to demographic variables, received treatment, associated complications and hospitalization time. Results: 18 patients are identified, 13 men and 5 women, 45 (± 36-51) and 34 (± 23-64) years respectively. It was possible to manually extract via trans-anal at box, in one of these cases; 17 of them required treatment at surgical pavilion, where 12 were via trans-anal and 5 via abdominal. None of these cases had intestinal injury. Post-surgery evolution was adequate. Average hospitalization was 1.8 days. Conclusion: RFB is a non-frequent problem which requires high diagnose suspicious to be able to carry out proper treatments. It is more frequent in middle age men, with transanal input. In most cases, the extraction was done in surgical pavilion and required anesthesia and were done via trans anal with good results. [ABSTRACT FROM AUTHOR]

We occasionally encounter patients with various types of rectal foreign bodies. When too large to grasp, transanal removal can be difficult. Here, we report a case of successful manual transanal removal of an 18 × 4 × 4 cm silicon rod without complications. A 50-year-old male came to the emergency department of our hospital 12 h after transanal insertion of a whole silicon rod. An abdominal examination showed no evidence of peritonitis, while X-ray and computed tomography findings revealed a large foreign body in the rectum, without any sign of perforation. Initially, we attempted removal using an endoscopy procedure with conventional endoscopic instruments, including a snare and grasp forceps, though we failed because of the large size. Next, we manually compressed the foreign body from the abdominal wall under endoscopic and X-ray fluoroscopic observation, and successfully removed it in a transanal manner without complications. Endoscopic and X-ray fluoroscopic assistance were helpful to guide the direction and angle of abdominal compression in this case.

In this report we present a 39 years old patient who claims to be sexually assaulted by anal foreign body insertion. His statements were contradictious and he has no lesions on anal region. Abdominal examination of the patient revealed hyperactive bowel sounds and tenderness on left lower quadrant. Only a fissure with dimensions of 0,4 x 0,1 cm's at the 7 o'clock position is detected. Anal folds were hyperemic and edematous. In digital examination, tonus was normal and ampulla was empty. Ten cm’s proximal to rectum, a metal foreign body was detected by anascopy. Under general anesthesia, the foreign body was manipulated and taken through the rectum. Psychopathological etiologies should be taken under consideration because of contradictious statements of the patient and absence of any traumatic lesions on genital region and other body parts.

Rectal foreign body is not an uncommon encounter in current medical practice. It reported occurs due to sexual eroticism, sexually abuse, assault or involuntary insertion. This condition possesses significant challenge among general surgeons on handling these cases. Diagnosis usually made by history taking, physical and radiological examination. We presented a case of a 43years old mentally challenge gentleman with retained rectal foreign body of three-week duration whom presented with non-specific abdominal pain, abdominal mass and loose stool. Due to low suspicion of rectal foreign body, the management flow skid from the norm. Attempt of removing rectal foreign body by various method was unsuccessful and his had to undergone exploratory laparotomy. Hence, propose flow of management in rectal foreign body is also included in this report. [ABSTRACT FROM AUTHOR]

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., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Frendt et al.)

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.

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Though common, the extraction of rectal foreign bodies is still a great challenge for surgeons. The foreign body's position can usually be verified by plain abdominal radiography. Given the potential of sexually transmitted disease, screening for HIV, hepatitis, and syphilis is warranted prior to intervention. The utilization and selection of surgical instruments need to be flexible, ingenious, and innovative.

We occasionally encounter patients with various types of rectal foreign bodies. When too large to grasp, transanal removal can be difficult. Here, we report a case of successful manual transanal removal of an 18 × 4 × 4 cm silicon rod without complications. A 50-year-old male came to the emergency department of our hospital 12 h after transanal insertion of a whole silicon rod. An abdominal examination showed no evidence of peritonitis, while X-ray and computed tomography findings revealed a large foreign body in the rectum, without any sign of perforation. Initially, we attempted removal using an endoscopy procedure with conventional endoscopic instruments, including a snare and grasp forceps, though we failed because of the large size. Next, we manually compressed the foreign body from the abdominal wall under endoscopic and X-ray fluoroscopic observation, and successfully removed it in a transanal manner without complications. Endoscopic and X-ray fluoroscopic assistance were helpful to guide the direction and angle of abdominal compression in this case. [ABSTRACT FROM AUTHOR]

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. © 2015 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

INTRODUCTION Rectal foreign bodies are rare colorectal emergencies. They are important for the complications that may occur. Delayed response causes a wide range of complications or may even result in death. PRESENTATION OF CASE A 22 years old male patient was seen at our hospital with anal pain, discharge, and complaining of incontinence. The patient stated that a bottle of beverage was placed into his anal canal in an inverted manner for sexual satisfaction 5 years previously. DISCUSSION After clinical and radiological assessment under general anaesthesia in the lithotomy position the object was removed by a laparotomy. He was advised to seek legal help and he received psychiatric treatment in the postoperative period prior to his discharge. CONCLUSION Complications such as abscess, perianal fistula complicated by severe pelvic sepsis and osteomyelitis were expected complications in this case. As in this case, a surgical approach may eliminate dissection planes, increasing morbidity and mortality related to the injuring of surrounding bodies during object extraction. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]