Management of Asymptomatic Perforation of a Pediatric Rectal Foreign Body into the Peritoneal Cavity Retrieved with Laparoscopy: A Case Report and Review of the Literature

Abstract

Rectal foreign body insertion has had an increasing trend throughout the years, whereas it is rarely reported in pediatrics. The management and treatment of these cases can become challenging, since it also can present with atypical or even no symptoms in physical evaluation. A 14-year-old boy was referred to our hospital with a history of insertion of a paintbrush into his anus four weeks before the admission. The paintbrush had perforated the colon and was in the abdominopelvic cavity; however, no symptoms of peritonitis were observed. Rectal examination, sigmoidoscopy, and colonoscopy were unremarkable. Exploratory laparoscopy was performed, and the paintbrush was taken out completely. The patient was discharged in good condition. In cases with rectal foreign body insertion, perforation without causing peritonitis or acute abdomen is possible. In these conditions, imaging examinations play an essential role in managing the patients, and laparoscopy can be a proper procedure for retrieving the foreign body.

An asymptomatic perforation of the gastrointestinal tract caused by ingestion of foreign body: A case report

“…Accidental ingestion of foreign bodies was widespread, especially in children and adults with psychological problems 1,7 . Most foreign bodies were ingested orally, with 80–90% of ingested foreign bodies spontaneously passing through the gastrointestinal tract uneventfully within 1 week, 5 and some of that was involuntary or deliberate input rectally 4 ; in addition, they also could be the result of iatrogenic complications during surgical and interventions procedures, such as intrauterine device and surgical sponge and so on 8,9 . Less than 1% of patients who ingested a foreign body became symptomatic, caused by perforation of the gastrointestinal tract and required surgery 1,7,10,11 .…”

“…The ingestion of foreign bodies is very common, but patients rarely can recall the ingestion episode, making it difficult to diagnose, especially when the patient has no particular symptoms 1 . Foreign objects in the abdomen may be due to involuntary or deliberate input orally or rectally 2–4 . Approximately 80–90% of ingested foreign bodies can pass through the gastrointestinal tract spontaneously without causing symptoms within 1 week.…”

“…1 Foreign objects in the abdomen may be due to involuntary or deliberate input orally or rectally. [2][3][4] Approximately 80-90% of ingested foreign bodies can pass through the gastrointestinal tract spontaneously without causing symptoms within 1 week. Only less than 1% of the foreign body remained in the lumen, causing severe complications such as intestinal perforation or mucosal injury requiring surgical treatment.…”