Uniquities of Rectal Foreign Body
Description
Rectal foreign bodies often pose a challenging diagnostic and management dilemma that begins at the initial evaluation in the emergency room and continues till the post-extraction period. Objects can be inserted in to the rectum for diagnostic or therapeutic purposes, self-treatment of anorectal disease, during criminal assault or accidents, or for sexual purposes. Numerous objects, including various fruits and vegetables, nails, light bulbs, bottles, body spray cans have been described as retained rectal foreign bodies. Patients with rectal foreign bodies are embarrassed and often reluctant to state the true nature of their emergency room visit. As a result, they may present with a chief complaint of rectal pain or abdominal pain, bright red blood per rectum, inability to have a bowel movement, and rectal mucous leakage.[1] A systematic approach to the diagnosis and management of rectal foreign bodies is essential. The objective of this study is to present 2 unusual cases of accidental rectal foreign bodies in adults and case specific clinical presentation and surgical management. Case Series involving two unique cases of rectal foreign body received in emergency room of Sri Ramachandra Institute of Higher Education and Research and the surgical management of those cases. The social stigma surrounding self-introduced rectal foreign bodies leads to delay in seeking treatment. Rectal foreign bodies have a good chance of causing bowel perforation and hence post foreign body removal observation is vital to detect and prevent life threatening complications of perforation. If there is any doubt of perforation, a computed tomography scan with rectal contrast or rectal enema with watersoluble contrast can detect this potentially life-threatening complication. The use of minimally invasive operative techniques for impacted rectosigmoid foreign bodies has been described which is a combination of laparoscopic downward milking of the object followed by per anal extraction but it is recommended only for smooth foreign bodies and if successful, avoids the need for a full laparotomy and provides the benefit of early discharge from the hospital.[2] The presentation of rectal foreign bodies is at most times unpredictable due to the uniqueness of each case and surgical management should be customised according to the circumstance.