Rectal foreign body

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Rectal foreign bodies are in general, large foreign items found in the rectum that can be assumed to have been inserted through the anus, rather than reaching the rectum via the mouth. Smaller, ingested foreign bodies, such as bones eaten with food, can sometimes be found stuck in the rectum upon x-ray.

Rectal foreign bodies, and amateur attempts to remove them, can result in perforation of the bowel, which is a life-threatening medical emergency. Medical literature covers examples of items retrieved from patients' rectums. Rectal foreign objects are also the subject of a number of urban legends.

X Ray Examples

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  Rectal foreign body (Image courtesy of Dr Frank Gaillard)
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  Rectal foreign body (Image courtesy of Dr Frank Gaillard)
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  Rectal foreign body. Body packer. (Image courtesy of Dr Frank Gaillard)
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  Rectal foreign body (Image courtesy of Dr Frank Gaillard)
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  Rectal foreign body (Image courtesy of Dr Frank Gaillard)
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  Rectal foreign body (Image courtesy of Dr Frank Gaillard)

Case Example

A middle-aged male presented to the emergency department with abdominal discomfort. An abdominal radiograph was performed as shown. There is no evidence of perforation or obstruction. The patient was taken to operating room within 12 hours of presentation, with consent for colostomy. Under general anesthesia in the lithotomy position, dilatation of anal sphincter was performed and per rectum retrieval successful. These patients typically have a delayed presentation to the emergency department because of embarrassment and after multiple attempts at self removal. Respect for their privacy is a key factor in the patient’s care plan. ED physicians need to decide if removal of foreign body can be performed in the emergency department or surgical team to be notified. Operating room procedures include anal dilatation under GA, transrectal manipulation, bimanual palpation if necessary and withdrawal of foreign body. Laparotomy or laparoscopy are occasionally necessary. (Image courtesy of Andrew Roshan)