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      Five years with a rectal foreign body: A case report

      case-report

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          Abstract

          INTRODUCTION

          Rectal foreign bodies are rare colorectal emergencies. They are important for the complications that may occur. Delayed response causes a wide range of complications or may even result in death.

          PRESENTATION OF CASE

          A 22 years old male patient was seen at our hospital with anal pain, discharge, and complaining of incontinence. The patient stated that a bottle of beverage was placed into his anal canal in an inverted manner for sexual satisfaction 5 years previously.

          DISCUSSION

          After clinical and radiological assessment under general anaesthesia in the lithotomy position the object was removed by a laparotomy. He was advised to seek legal help and he received psychiatric treatment in the postoperative period prior to his discharge.

          CONCLUSION

          Complications such as abscess, perianal fistula complicated by severe pelvic sepsis and osteomyelitis were expected complications in this case. As in this case, a surgical approach may eliminate dissection planes, increasing morbidity and mortality related to the injuring of surrounding bodies during object extraction.

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          Most cited references9

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          Organ injury scaling, II: Pancreas, duodenum, small bowel, colon, and rectum.

          The Organ Injury Scaling (O.I.S.) Committee of the American Association for the Surgery of Trauma (A.A.S.T.) has been charged to devise injury severity scores for individual organs to facilitate clinical research. Our first report (1) addressed O.I.S.'s for the Spleen, Liver, and Kidney; the following are proposed O.I.S.'s for Pancreas (Table I), Duodenum (Table II), Small Bowel (Table III), Colon (Table IV), and Rectum (Table V). The grading scheme is fundamentally an anatomic description, scaled from 1 to 5, representing the least to the most severe injury. We emphasize that these O.I.S.'s represent an initial classification system which must undergo continued refinement as clinical experience dictates.
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            Rectal foreign bodies.

            Rectal foreign bodies present a difficult diagnostic and management dilemma because of delayed presentation, a variety of objects, and a wide spectrum of injuries. An orderly approach to the diagnosis, management, and post-extraction evaluation of the patient with a rectal foreign body is essential. This article outlines and describes the stepwise evaluation and management of the patient with a rectal foreign body. The authors also describe the varied techniques needed to successfully remove the different foreign bodies that may be encountered. Copyright 2010. Published by Elsevier Inc.
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              Management of retained colorectal foreign bodies: predictors of operative intervention.

              This study was designed to review experience at our hospital with retained colorectal foreign bodies. We reviewed the consultation records at Los Angeles County + University of Southern California General Hospital from October 1993 through October 2002. Ninety-three cases of transanally introduced, retained foreign bodies were identified in 87 patients. Data collected included patient demographics, extraction method, location, size and type of foreign body, and postextraction course. Of 93 cases reviewed, there were 87 individuals who presented with first-time episodes of having a retained colorectal foreign body. For these patients, bedside extraction was successful in 74 percent. Ultimately, 23 patients were taken to the operating room for removal of their foreign body. In total, 17 examinations under anesthesia and 8 laparotomies were performed (2 patients initially underwent an anesthetized examination before laparotomy). In the eight patients who underwent exploratory laparotomy, only one had successful delivery of the foreign object into the rectum for transanal extraction. The remainder required repair of perforated bowel or retrieval of the foreign body via a colotomy. In our review, a majority of cases had objects retained within the rectum; the rest were located in the sigmoid colon. Fifty-five percent of patients (6/11) presenting with a foreign body in the sigmoid colon required operative intervention vs. 24 percent of patients (17/70) with objects in their rectum (P = 0.04). This is the largest single institution series of retained colorectal foreign bodies. Although foreign objects located in the sigmoid colon can be retrieved at the bedside, these cases are more likely to require operative intervention.
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                Author and article information

                Contributors
                Journal
                Int J Surg Case Rep
                Int J Surg Case Rep
                International Journal of Surgery Case Reports
                Elsevier
                2210-2612
                24 November 2014
                24 November 2014
                2015
                : 6
                : 210-213
                Affiliations
                [a ]Dokuz Eylül University Faculty of Medicine, Department of General Surgery, İzmir, Turkey
                [b ]Kemalpasa State Hospital, General Surgery, Izmir, Turkey
                [c ]Bornova Türkan Özilhan State Hospital, General Surgery, Izmir, Turkey
                [d ]Tepecik Training and Research Hospital, 2nd General Surgery Department, Izmir, Turkey
                Author notes
                [* ]Corresponding author at: Kemalpaşa State Hospital, Kırovası Küme bulvarı 8 Eylül Mah. 8/1 Sk., 35170 Kemalpaşa, İzmir, Turkey. Tel.: +90 0505 3241633; fax: +90 0232 8788030. drbaha112@ 123456gmail.com
                Article
                S2210-2612(14)00404-0
                10.1016/j.ijscr.2014.11.053
                4334645
                25553525
                5fcf253e-6908-472e-9eff-b359ae3a272a
                © 2014 The Authors

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/3.0/).

                History
                : 3 July 2014
                : 30 October 2014
                : 8 November 2014
                Categories
                Article

                rectal foreign body,5 years,sexual abuse
                rectal foreign body, 5 years, sexual abuse

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