Retained Rectal Foreign Body: A Case Report

Background: Rectal foreign body is not an uncommon presentation in the surgical emergency. Its incidence is increasing especially in the Asian urban population. Patients are embarrassed and reluctant to seek medical care thereby delaying management. They have a varied presentation and depending on the size, position of the foreign object and whether there is rectal perforation or not, different approaches may be chosen to remove it.

Case Presentation: Here, we present a young Indian urban male who came to the emergency with complaints of inability to remove a foreign body that he inserted per rectally. Abdominal x-ray did not reveal a foreign body. Non-Contrast Enhanced Computed Tomography (NCCT) showed a foreign body in the rectum and sigmoid colon. Manual removal via proctoscopy and sigmoidoscopy failed. The patient underwent laparotomy, colostomy and removal of the foreign body with subsequent primary repair of the colotomy. Patient was symptomatically relieved and followed up with abdominal x-ray which showed no air under diaphragm. Patient was discharged on post-operative day-8 (POD-8).

Conclusion: A careful history and physical examination with a high index suspicion of perforation is necessary. A creative approach to removal and appropriate short term follow-up to detect delayed perforation are important in a case of retained rectal foreign body.