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Management of unusual rectal foreign body - Case report and literature review.

Authors:
Ana Elisa de Landa Moraes Teixeira Grossi Juan Eduardo Rios Rodriguez Alexia Aina de Freitas Sousa Danielle Alcântara Barbosa Machado Victor Vinícius Monteiro Lins de Albuquerque Frank Pinheiro Pessoa Coelho de Macedo

Int J Surg Case Rep 2022 May 6;94:107051. Epub 2022 Apr 6.

Digestive System Surgery service at Getúlio Vargas University Hospital (HUGV), Manaus, Brazil.

Introduction: Retained rectal objects represent a rare complaint in the emergency room, affecting mainly males between 20 and 40 years, with most objects of a sexual nature, but the examiner must be aware of objects of an unusual nature.

Presentation Of Case: A 54-year-old male patient arrives at the surgical emergency department, with a report of an accident with the insertion of an object via the rectum, a gym dumbbell. Initially opted for transrectal object removal, but with difficulties due to its position.

Discussion: Retained rectal objects are a rare complaint in the emergency department, but with an increasingly important occurrence in recent years. Physical examination should include an assessment of the abdomen and digital rectal examination. Imaging tests are mandatory for diagnosis, with abdominal and pelvis radiography being the most requested. Although there is no consensus on the most appropriate removal technique, less invasive initial approaches are recommended, with transanal removal with a 60-75% success rate under local anesthesia. The follow-up after the procedure depends on several factors, and in general, the patient should be kept under observation and attention should be paid to significant changes in the evolution and alterations in the imaging tests.

Conclusion: The clinical history in these cases can be confusing, due to the patient's fear of reporting the complaints. Radiography is the best initial test, and CT is reserved for cases of suspected complications. Whenever possible, perform the extraction rectally.

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http://dx.doi.org/10.1016/j.ijscr.2022.107051DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9048151PMC
May 2022

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