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The Management of Retained Rectal Foreign Body

Annals of Coloproctology 2020년 36권 5호 p.335 ~ 343
김주훈, 엄은해, 정성민, 신용찬, 정성원, 김재일, 허태길, 이명수, 전흥만, 최평화,
소속 상세정보
김주훈 ( Kim Ju-Hun ) - Inje University College of Medicine Ilsan Paik Hospital Departments of Surgery
엄은해 ( Um Eun-Hae ) - Inje University College of Medicine Ilsan Paik Hospital Department of Surgery
정성민 ( Jung Sung-Min ) - Inje University College of Medicine Ilsan Paik Hospital Department of Surgery
신용찬 ( Shin Yong-Chan ) - Inje University College of Medicine Ilsan Paik Hospital Department of Surgery
정성원 ( Jung Sung-Won ) - Inje University College of Medicine Ilsan Paik Hospital Department of Surgery
김재일 ( Kim Jae-Il ) - Inje University College of Medicine Ilsan Paik Hospital Departments of Surgery
허태길 ( Heo Tae-Gil ) - Inje University College of Medicine Ilsan Paik Hospital Departments of Surgery
이명수 ( Lee Myung-Soo ) - Inje University College of Medicine Ilsan Paik Hospital Departments of Surgery
전흥만 ( Jun Heung-Man ) - Inje University College of Medicine Ilsan Paik Hospital Departments of Surgery
최평화 ( Choi Pyong-Wha ) - Inje University College of Medicine Ilsan Paik Hospital Departments of Surgery

Abstract


Purpose: Because insertion of a foreign body (FB) into the anus is considered a taboo practice, patients with a retained rectal FB may hesitate to obtain medical care, and attending surgeons may lack experience with removing these FBs. We performed this study to evaluate the clinical characteristics of Korean patients with a retained rectal FB and propose management guideline for such cases based on our experience.

Methods: We retrospectively investigated 14 patients between January 2006 and December 2018. We assessed demographic features, mechanism of FB insertion, clinical course between diagnosis and management, and outcomes.

Results: All patients were male (mean age, 43 years) and presented with low abdominal pain (n = 2), anal bleeding (n = 2), or concern about a retained rectal FB without symptoms (n = 10). FB insertion was most commonly associated with sexual gratification or anal eroticism (n = 11, 78.6%). All patients underwent general anesthesia for anal sphincter relaxation with the exception of 2 who underwent FB removal in the emergency department. FBs were retrieved transanally using a clamp (n = 2), myoma screw (n = 1), clamp application following abdominal wall compression (n = 2), or laparotomy followed by rectosigmoid colon milking (n = 2). Colotomy and primary repair were performed in four patients, and Hartmann operation was performed in one patient with fecal peritonitis. No morbidity or mortality was reported. All patients refused postextraction anorectal functional and anatomical evaluation and psychological counseling.

Conclusion: Retained rectal FB is rare; however, colorectal surgeons should be aware of the various methods that can be used for FB retrieval and the therapeutic algorithm applicable in such cases.

키워드

Foreign body; Rectum; Management

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