Colorectal foreign bodies

Abstract

Objective: A pictorial review of colorectal foreign bodies and their extraction.

Methods: A prospective data-base and photographic record of patients who presented with retained colorectal foreign bodies at our institution has been maintained since 1995. Information regarding the foreign body, clinical presentation and extraction technique were documented.

Results: All 13 patients were male: age range 2-66 years. Seven were Caucasian, 4 African and 1 Asian. The foreign bodies included a penknife, an aerosol deodorant spray can, a blue plastic tumbler, a plastic bag containing two bank-notes and some marijuana, a plastic packet containing fish hooks, a penlight torch, a broomstick, a battery powered vibrator, a primus stove, a cap of an aerosol can, a piece of wire, a piece of hosepipe wrapped with wire and an iron bar. They entered the alimentary tract for a variety of reasons; anal autoeroticism (3), concealment (2), attention seeking behaviour (3), accidental (1), assault (2) and to alleviate constipation (2). Plain radiographs accurately demonstrated the site of the foreign body in 8 patients. Extraction was at laparotomy in 2 patients with peritonitis and in 3 who required extraction by colotomy. In 7 patients who had transanal extraction, four required general anaesthesia to facilitate extraction and extraction was possible under conscious sedation in the emergency room in three. The remaining patient extracted the foreign body himself and presented to hospital with a rectal perforation.

Conclusion: The emergency room physician must confirm the presence of a rectal foreign body. Extraction in the emergency room is usually not possible and patient's with retained rectal foreign bodies should be referred to a colorectal surgeon.