Surgical management of rectal foreign bodies: a 10-year single-center experience

Abstract

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,

Kolorektale Fremdkörper – eine Herausforderung für Patient und Arzt

“…Eine zügige Entfernung in der Notaufnahme ohne Gabe einer Narkose war in dieser hier vorliegenden Serie nur bei 2 von 9 Patienten erfolgreich, obwohl der Fremdkörper im Rektum lokalisiert war. In der kürzlich publizierten deutschsprachigen Arbeit von Kokemohr et al lag die Erfolgsrate hingegen bei 70 % [4]. Auch wenn der Fremdkörper im Rektum lokalisiert und tastbar ist, kann sich die Entfernung durch die sakrale Kurvatur und den mit jeder erneuten Manipulation zunehmenden Sphinktertonus erschweren [21].…”

“…Fallberichte ziehen sich in der Literatur durch sämtliche Jahrzehnte [2]. Manche Autoren beschreiben gar eine steigende Inzidenz [3,4].…”

Unusual presentation of a rectal foreign body: a diagnostic dilemma

“…Diagnostic dilemmas often arises as patients are sometimes unwilling to disclose the actual history and seek medical attention late. 1,2 Ooi et al from a study of 35 patients reported that only 33% admit to transanal insertion, while 67% complained of anal pain at the point of presentation. 3 Other presentations are per-rectal bleeding, mucous discharge, there are reported cases of local injury or perforation in attempts to remove the object.…”

“…3 Other presentations are per-rectal bleeding, mucous discharge, there are reported cases of local injury or perforation in attempts to remove the object. 1 Various types of foreign body have been reported, from bottles to bones, toys, fruits, vegetables, drugs, pipe hose, egg ornament, sprays, cans and many more. 2,4 Majority of cases are inserted via anus for sexual adventures voluntarily and occasionally as result of assault or rape.…”

“…2,4 Majority of cases are inserted via anus for sexual adventures voluntarily and occasionally as result of assault or rape. 1 Most report successful transanal extraction with or without sedation, some with aid of tools and endoscopy, however some require a laparotomy where there was significant bowel injury or perforation. 4 We have encountered many rectal foreign bodies in our centre for the past few years, however this is the first rare form of foreign body with an unusual presentation.…”