Rectal foreign body

Rectal foreign body refers to any object found in the rectum that is not meant to be there. This medical condition can arise from various circumstances, including accidental insertion, sexual activity, or the swallowing of objects that subsequently become lodged in the rectum. The management of rectal foreign bodies is a challenging aspect of emergency medicine and requires a multidisciplinary approach for safe removal and to minimize patient discomfort and potential complications.

Causes

Rectal foreign bodies can be introduced into the rectum through various means. Common causes include:

• Intentional insertion: Objects may be inserted into the rectum for sexual gratification, out of curiosity, or for concealment of contraband.
• Accidental insertion: This can occur during falls or when sitting on an object.
• Swallowed objects: In rare cases, swallowed objects can pass through the entire gastrointestinal tract and become lodged in the rectum.

Symptoms

Symptoms of a rectal foreign body may vary depending on the size, shape, and nature of the object, as well as the duration it has been lodged. Common symptoms include:

• Abdominal pain
• Rectal pain or discomfort
• Bleeding from the rectum
• Inability to defecate or pass gas
• Visible part of the object from the anus in some cases

Diagnosis

Diagnosis of a rectal foreign body typically involves:

• Medical history and physical examination: A thorough history and physical examination can provide crucial information about the object and the circumstances of its insertion.
• Imaging studies: X-rays, CT scans, or MRI may be used to locate the object, assess its size and shape, and evaluate for potential complications such as perforation or obstruction.

Management

The management of rectal foreign bodies focuses on the safe removal of the object while minimizing trauma and the risk of complications. Approaches include:

• Manual extraction: Attempted in the emergency department under sedation or anesthesia, especially if the object is within reach.
• Endoscopic removal: Flexible sigmoidoscopy or colonoscopy can be used to remove objects beyond the reach of manual extraction.
• Surgical intervention: Required in cases where non-invasive methods are unsuccessful or if there is evidence of complications such as perforation or significant bleeding.

Complications

Complications from rectal foreign bodies can be serious and include:

• Perforation of the rectum or colon
• Infection, including abscess formation
• Significant bleeding
• Bowel obstruction

Prevention

Prevention of rectal foreign bodies involves education on the risks associated with the insertion of objects into the rectum and promoting safer sexual practices.

See also

• Gastrointestinal perforation
• Foreign body (medicine)
• Sexual health