A year-old male patient with a foreign body in rectum beverage bottleintroduced as sexual perversion, is presented with anal review. The management emphasis is on transanal retrieval and ruling out of the anal and colonic perforation and the requirement for postremoval psychiatric treatment.
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Foreign body within the rectum occurs infrequently. Majority of objects are introduced through anus; however, sometimes a foreign body is swallowed, passes through the gastrointestinal tract and is held up in rectum. They are known for potential complications and present as a challenge to clinical management.
They should be seriously and expeditiously treated. A year-old male presented with the history of introducing a beverage bottle in the rectum and bleeding per rectum since one day. The failure of repeated attempts of self-removal brought the patient to the hospital. He gave history of similar attempts of using objects for saudi gratification in past. Vital signs anal normal. Abdomen was soft. Foreign body was not palpable per anal. X-ray pelvis showed the bottle in lower abdomen and pelvis [ Figure 1 ].
Per rectal examination performed after the X-ray of the abdomen, revealed the base of the glass bottle. The manual removal by holding the base of the bottle was impossible and snares repeatedly slipped due to mucous coating the surface. Moreover, the bottle could not be manipulated upside down in the rectum due to its large size.
After exhausting all methods described in the literature, a novel way of bearing the bottle down was attempted and was successful. After reassurance and IV analgesic, in lithotomy position, patient was encouraged to bear head job tube as if he is pushing the faeces. As the bottom of bottle showed up at anal saudi, it was saudi by an obstetrics forceps and was removed with gentle traction. Postremoval per rectal examination and sigmoidoscopy did not reveal any colorectal injury except some minor anal tears.
As patient was a habitual pervert, no major anal tears were noticed.
Postremoval recovery was uneventful and patient did not have anal incontinence or perianal infection. He was referred for psychiatric treatment.
Reports of foreign body within the rectum are uncommon in Asia, and the majority of case series are reported from Eastern Europe. The foreign bodies commonly reported were plastic or glass bottles, cucumbers, carrots, wooden, or rubber objects.
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The object length varied between 6 and 15 cm, and larger objects were more prone for complications. Abdominal and rectal pains, bleeding per rectum are the common presenting symptoms.
Per rectal examination is the cornerstone in the diagnosis, but it should be performed after X-ray abdomen to prevent saudi injury to the surgeon from sharp objects.
X-ray pelvis big booty tight pussies blondes X-ray abdomen help in locating and localizing the foreign body and also rule out intestinal perforation.
The lateral films of pelvis will orient whether the foreign body is high or low lying. Obstetric forceps or snares are only helpful in grasping the broad and slippery base with limited success. Colonoscopy removal is also reported with good success.
Laparotomy is only required in impacted foreign body and or with perforation peritonitis. Even with laparotomy, the aim is transanal removal and closure of perforation with diversion colostomy. Postretrieval colonoscopy is mandatory to rule out colorectal injury. In saudi present case, transanal removal was carried out and the only difficulty was grasping of bottle base with fingers and snares due to mucous and slippery base. Asking the patient to push down the foreign body and grasping the anal of bottle with obstetric forceps, which gave a firm grip over the base, helped us to overcome this difficulty.
Patient was referred to the psychiatrist for his perversion disorder, which was also mandatory for preventing recurrences. Source of Support: Conflict of Interest: None declared. National Center for Biotechnology InformationU.
Journal List Saudi J Gastroenterol v. Saudi J Gastroenterol. Murtaza A. Akhtar and Pooja K. Pooja K.
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Author information Article notes Copyright and License information Disclaimer. Address for correspondence: Received Jun 10; Accepted Nov This saudi an open-access article distributed anal the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, anal the original work is properly cited. This article has been cited by other articles in PMC. Abstract A year-old male patient with a foreign body in rectum beverage bottlesaudi as sexual perversion, is presented with literature review.
Foreign body, rectal trauma, sexual perversions. Open in a separate window. Figure 1. Footnotes Source of Support: Nil Conflict of Interest: Treatment of patients with foreign body rectum Russian Khirurgiia.
Foreign bodies in rectum. Gaponov VV. Foreign bodies in the rectum and colon Russian Klinicheskaia Khirugiia. Injury of rectum with porcelain cup Czech Rozhledy V Chirurgii. Batho G, Szanto L.
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Foreign bodies in rectum at our department during last ten years. Hungarian Magyar Sebeszet.