Rectal Foreign Bodies in Older Men: a Novel Challenge and Humanistic Care for the Society

Abstract Background: In recent years, rectal foreign bodies are a common proctological emergency in the male population, especially in Chinese elderly men that often requires the intervention of the surgeon due to its complications. The aim of this review is to describe the epidemiology and clinical characteristics of rectal foreign bodies in elderly men and its possible challenge to clinicians and society. Methods: A comprehensive literature search was conducted in English databases (PubMed, Embase, Web of Science, the Cochrane Library) and Chinese databases (CNKI, Wan Fang, VIP, Chinese biomedical database) from January 2000 to December 2020. All rectal foreign bodies relevant studies were considered, if they reported the purpose for a foreign body in the rectum and related treatment measures. Contemporaneous rectal foreign bodies cases data from our center were also analyzed. Two authors independently extracted the data and reviewed the quality of the included research. According to the differences in population background, we divided the elderly Chinese male group and the elderly non-Chinese male group, the parameters of the two groups were analyzed by statistical methods.Results: A total of 159 literatures were preliminarily retrieved in initial literature search with rectal foreign body as the search term, including 86 Chinese literatures and 73 English literatures. A total of 582 patients were the elderly male patients, included 276 Chinese patients and 307 non-Chinese patients. In older men, the sources of foreign bodies can be divided into three categories: the ones that are inserted from the anus, the ones that are swallowed and thereafter become stuck in the rectum, the other that are caused by improper medical practices. The most common purpose for a foreign body in the rectum was insertion for erotic purposes. In the foreign body type, the daily articles account for the majority. Sexual articles are mainly found in pleasure seekers. There was no significant difference in foreign body sources, size, type, treatment selection and outcome between the two groups.Conclusions: In older men, there is an increasing number of cases of rectal foreign body emergency visits for erotic purposes and sexual needs. Although the source, size and type of foreign body are different, and patients can get a better recovery after active and appropriate clinical treatment, the sexual needs are social problem we should pay attention to in older men. Treatment of sexual issues is a multidimensional task that should be implemented as a collaborative effort and older people should get more humanistic care in this regard.

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Deodorant aerosol spray can in the rectum: a potential fire hazard during surgery

BMJ Case Reports ◽

10.1136/bcr-2020-241538 ◽

2021 ◽

Vol 14 (5) ◽

pp. e241538

Author(s):

Sivaraman Kumarasamy ◽

Lileswar Kaman ◽

Azhar Ansari ◽

Amarjyoti Hazarika

Keyword(s):

Foreign Body ◽

Surgical Procedures ◽

Foreign Bodies ◽

Fire Hazard ◽

Psychiatric Patients ◽

Young Male ◽

Energy Devices ◽

Aerosol Spray ◽

Rectal Foreign Bodies ◽

Fire And Explosion

Rectal foreign bodies are not uncommon and often pose a serious challenge to surgeons. In majority, the objects are inserted by self in children, psychiatric patients and for sexual gratification in adults. Various rectal foreign bodies have been reported. Deodorant aerosol spray can in the rectum has not been reported previously. Danger of aerosol dispenser can is the risk of fire and explosion. Especially during any surgical procedures to remove the foreign body using cautery or any energy devices. We report of a rare foreign body of deodorant aerosol spray can in the rectum in a young male patient, which was removed under general anaesthesia.

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A new and simple extraction technique for rectal foreign bodies: removing by cutting into small pieces

Surgical Techniques Development ◽

10.4081/std.2014.5538 ◽

2014 ◽

Vol 4 (1) ◽

Author(s):

Abbas Aras ◽

Mehmet Karabulut ◽

Osman Kones ◽

Kaplan Baha Temizgonul ◽

Halil Alis

Keyword(s):

Foreign Body ◽

Foreign Bodies ◽

Simple Technique ◽

Intestinal Wall ◽

Fruit And Vegetables ◽

Extraction Technique ◽

Rectal Foreign Bodies ◽

Simple Extraction

The purposes of insertion and types of foreign bodies in rectum show great variation. Rectal foreign bodies need to be removed without giving damage to intestinal wall and this should be done in the easiest possible way. We have reported a new and a simple technique. It is easy to apply and safe. A patient was admitted to our clinic with a rectal foreign body (radish) which was successfully removed by cutting it into small pieces. We conclude that different kinds of rectal foreign bodies, especially fruit and vegetables, can be removed by this technique.

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Denture Impaction Causing an Upper Esophageal Diverticulum

Case Reports in Gastrointestinal Medicine ◽

10.1155/2019/9621383 ◽

2019 ◽

Vol 2019 ◽

pp. 1-4

Author(s):

Shireen Samargandy ◽

Hani Marzouki ◽

Talal Al-Khatib ◽

Mazin Merdad

Keyword(s):

Foreign Body ◽

Foreign Bodies ◽

The Elderly ◽

Barium Swallow ◽

Diagnostic Challenge ◽

Case Presentation ◽

History Of ◽

Endoscopic Diverticulotomy ◽

Tomography Scan ◽

Rule Out

Background. Dentures are a common cause of inadvertent foreign body ingestion particularly in the elderly. Due to their radiolucent nature, they often present a diagnostic challenge to care providing physicians. Case Presentation. A 66-year-old female presented to our otolaryngology clinic with a 2-year history of dysphagia. Her physical examination was unremarkable. Computed tomography scan of the neck and barium swallow suggested Zenker diverticulum. She was planned for endoscopic diverticulotomy; however, during surgery, a foreign body was incidentally found and retrieved, which was a partial lower denture. The diverticulum resolved thereafter, and the patient's symptoms abated. Conclusion. The authors recommend evaluating the esophagus endoscopically first in cases of upper esophageal diverticular formation, even when planning an open repair approach, to rule out any concealed foreign bodies.

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PS01.099: RETROSPECTIVE ANALYSIS OF CLINICAL FEATURES OF 202 CASES WITH ESOPHAGEAL FOREIGN BODIES

Diseases of the Esophagus ◽

10.1093/dote/doy089.ps01.099 ◽

2018 ◽

Vol 31 (Supplement_1) ◽

pp. 77-77

Author(s):

Jinteng Feng ◽

Kun Fan ◽

Rui Gao ◽

Junke Fu ◽

Guangjian Zhang

Keyword(s):

Foreign Body ◽

Clinical Features ◽

Foreign Bodies ◽

Conflicts Of Interest ◽

The Elderly ◽

General Information ◽

Diagnostic Methods ◽

Practical Significance ◽

Esophageal Foreign Body ◽

Esophageal Foreign Bodies

Abstract Background Esophageal foreign bodies refer to objects that are accidentally or intentionally swallowed, or that are naturally swallowed during medication or eating, temporarily staying in or resting in the esophagus. Esophageal foreign body is one of the common emergency of esophageal surgery, more common in the elderly and children. This paper study clinical features of esophageal foreign body in northwestern China in order to improve the abilities of diagnosis and treatment for the disease. Methods Clinical data of 202 patients admitted in for esophageal foreign body was analyzed retrospectively. The general information of the patients were collected, and the types of foreign bodies, the location, diagnostic methods, methods of taking out and related complications, hospitalization days, et al were analyzed statistically. Results The types of esophageal foreign body included jujube pit (61.8%), animal bones (12.9%) and non-food foreign bodies (24.3%). It mainly occurred in the upper orifice of the esophagus (65.8%). Diagnostic methods were mainly consisted of esophageal angiography (57.9%), chest X-ray (19.8%) and endoscopy (16.4%). Most of the patients (189, 93.6%) were treated with esophagoscopy. Altogether 26 cases presented with complications, and 18 of them were admitted in for jujube pit. Conclusion The main cause of esophageal foreign body is jujube pit. Early diagnose and timely management is essential for the disease. How to guide the population as far as possible to avoid ingesting jujube pit wrongly and reduce the incidence of esophageal foreign body is of practical significance. Disclosure All authors have declared no conflicts of interest.

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Rectal Foreign Bodies:A Retrospective Study

International Journal of Medical and Dental Sciences ◽

10.18311/ijmds/2017/18791 ◽

2017 ◽

Vol 6 (1) ◽

pp. 1367

Author(s):

Nishith M. Paul Ekka ◽

Shital Malua ◽

Pankaj Bodra

Keyword(s):

Retrospective Study ◽

Foreign Body ◽

Foreign Bodies ◽

Case Reports ◽

Demographic Data ◽

Case Series ◽

Rectal Foreign Bodies ◽

Obstetric Forceps ◽

Transanal Extraction ◽

Manual Extraction

Background: Reported incidence of rectal foreign bodies is rather rare with only isolated published case reports or case series. Controlled studies of patients with rectal foreign bodies have not been conducted. The approach to the management of these patients has not changed in the last 10-20 years.Objective: The aim of this study was to describe 16 cases of colorectal foreign bodies introduced during sexual activity, gathered by the authors from 2002 to 2016, and to establish an epidemiological and therapeutic pattern.Material and methods: This was a retrospective study that involved retrieval of folders belonging to patients who were treated for foreign body of rectum. The patients demographic data along with type of object (Foreign body), time of presentation and type of treatment required were recorded from the case folders.Results: All the 16 patients in our series were male with a mean age of 42 years. Household bottles (37.8%) were the most common foreign body while a majority of patients presented between 24 to 48 hrs. Laparotomy was done in 8 cases (50%) out of which in 7 cases transanal extraction was done by milking while in 1 case colostomy was done. Manual extraction was successful in 25% while forceps were helpful in another 25%.Conclusions: The incidence of rectal foreign bodies is disproportionately higher in men. Manual extraction with or without the help of obstetric forceps appears to be the treatment modality of choice. The appropriate technique will depend on the size and surface of the retained object and the presence of complications.

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Overtubes and Foreign Bodies

Canadian Journal of Gastroenterology ◽

10.1155/1990/963194 ◽

1990 ◽

Vol 4 (9) ◽

pp. 599-602 ◽

Cited By ~ 3

Author(s):

Norman E Marcon

Keyword(s):

Foreign Body ◽

Foreign Bodies ◽

The Elderly ◽

Flexible Endoscopy ◽

X Rays ◽

Glass Bottle ◽

New Techniques ◽

Foreign Body Removal ◽

Gastrostomy Tubes ◽

Button Batteries

The most common article ingested in adults is food or food products such as nuts, shells, pits and bones. Poorly chewed steak causing bolus obstruction occurs especially in the elderly, while coins are most common in the pediatric group. New techniques of flexible endoscopy have altered and improved management, decreasing the need for surgery. A foreign body in the esophagus mandates prompt removal to avoid perforation. At least 80% of foreign, bodies reaching the stomach pass spontaneously. Once the foreign body is beyond the distal duodenum, it should be followed with serial x-rays. Techniques of removal of meat, bones, shells, bezoars, glass, bottle tops, sharps, pencils, pens, wires, thermometers, gastrostomy tubes, obesity balloons, safety pins, razor blades, button batteries and cocaine packets are described. Complications related to foreign body removal are rare.

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The Fears Expressed by Elderly Men and Women: A Lifespan Approach

The International Journal of Aging and Human Development ◽

10.2190/g072-ntgc-t3p4-ljda ◽

1988 ◽

Vol 26 (2) ◽

pp. 139-146 ◽

Cited By ~ 14

Author(s):

James W. Croake ◽

Kathleen M. Myers ◽

Abe Singh

Keyword(s):

Children And Adolescents ◽

Older Women ◽

Elderly Population ◽

The Elderly ◽

Older Men ◽

Elderly Group ◽

Elderly Men ◽

Single Measure ◽

Men And Women ◽

Comparison Groups

This article reports one of the first studies of adult fears, specifically in an elderly population. Results indicated that older women expressed greater fearfulness than older men, a sex differential also observed in children and adolescents. When compared to other adult groups, significant differences were noted on several categories of fears. The elderly group ranked aging and sickness as their foremost fears, although the absolute degree of fearfulness did not differ from the comparison groups. Considered with previous investigations, these results suggest that some fears may change or intensify over the lifespan, and that within each period females report greater fearfulness than males. Additionally, this article describes a new entity, “fisity,” which accounts for the popularity and the intensity of fears in a single measure.

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Unusual presentation of a rectal foreign body: a diagnostic dilemma

International Surgery Journal ◽

10.18203/2349-2902.isj20192998 ◽

2019 ◽

Vol 6 (7) ◽

pp. 2587

Author(s):

Pei Pei Lee ◽

Jitt Aun Chuah ◽

Ratha Krishnan Sriram

Keyword(s):

Foreign Body ◽

Acute Urinary Retention ◽

Foreign Bodies ◽

Correct Diagnosis ◽

Medical Attention ◽

Pelvic Cavity ◽

Diagnostic Dilemma ◽

Rectal Foreign Bodies ◽

History Of ◽

Abdominal Perineal Resection

Rectal foreign bodies present a challenge to surgeons from obtaining the correct diagnosis to managing the patient due to a wide array of presentation. Diagnostic dilemmas often arise as patients are sometimes unwilling to disclose the actual history and seek medical attention late. We present a case of a 65 year old Asian gentleman who present with history of per-rectal bleeding, tenesmus, acute urinary retention, constitutional symptoms with investigations suggestive of rectal malignancy. Intraoperatively identified a rubber-like foreign body tightly packed in the pelvic-cavity with severe injury to the rectum requiring abdominal-perineal resection.

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Successful Transanal Removal of a Rectal Foreign Body by Abdominal Compression under Endoscopic and X-Ray Fluoroscopic Observation: A Case Report

Case Reports in Gastroenterology ◽

10.1159/000452210 ◽

2016 ◽

Vol 10 (3) ◽

pp. 646-652 ◽

Cited By ~ 4

Author(s):

Hironobu Mikami ◽

Norihisa Ishimura ◽

Akihiko Oka ◽

Ichiro Moriyama ◽

Takafumi Yuki ◽

...

Keyword(s):

Computed Tomography ◽

Emergency Department ◽

Case Report ◽

Foreign Body ◽

Foreign Bodies ◽

Abdominal Compression ◽

X Ray ◽

Large Size ◽

Rectal Foreign Bodies ◽

Abdominal Examination

We occasionally encounter patients with various types of rectal foreign bodies. When too large to grasp, transanal removal can be difficult. Here, we report a case of successful manual transanal removal of an 18 × 4 × 4 cm silicon rod without complications. A 50-year-old male came to the emergency department of our hospital 12 h after transanal insertion of a whole silicon rod. An abdominal examination showed no evidence of peritonitis, while X-ray and computed tomography findings revealed a large foreign body in the rectum, without any sign of perforation. Initially, we attempted removal using an endoscopy procedure with conventional endoscopic instruments, including a snare and grasp forceps, though we failed because of the large size. Next, we manually compressed the foreign body from the abdominal wall under endoscopic and X-ray fluoroscopic observation, and successfully removed it in a transanal manner without complications. Endoscopic and X-ray fluoroscopic assistance were helpful to guide the direction and angle of abdominal compression in this case.

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Aerodigestive and Ear Foreign Bodies at Lumbini Medical College

Journal of Lumbini Medical College ◽

10.22502/jlmc.v1i1.1 ◽

2013 ◽

Vol 1 (1) ◽

pp. 1

Author(s):

Anup Acharya ◽

Madan Mohan Singh ◽

Sushil Shah

Keyword(s):

Foreign Body ◽

Primary Care Physicians ◽

Foreign Bodies ◽

Demographic Data ◽

The Elderly ◽

Cross Sectional ◽

Male Predominance ◽

Medical College ◽

Sociodemographic Correlates ◽

One Year

Introduction: Aerodigestive and Ear foreign bodies are common Ear Nose Throat (ENT) emergencies. They arecommonly encountered by otolaryngologists, paediatricians, and primary care physicians. Objective: The aim ofthis study is to analyze different types of foreign bodies and sociodemographic correlates of self-inflicted foreign body insertion in ear, nose and throat. Method: Seventy-four patients with aerodigestive foreign body coming to our Hospital over a period of one year, starting from January 1, 2012, were enrolled in the study. Hospital based cross sectional descriptive study was done. Socio-demographic data was collected by history and clinical examination of all those patients. The data collected from 74 patients were entered and analyzed using descriptive and analytical statisticalmethods using SPSS version 17.0. Result: There were total of 74 cases of ENT foreign body. Male predominance was noted (61%). Foreign body of ear was found to be most frequent (43%) followed by throat (37%) and nose (20%). Foreign body of nose was almost limited in paediatrics population (14 out of 15) whereas in the elderly group foreign body of throat was only found. Seeds, meat bolus or bone or both, insects and cotton bud were the most common foreign bodies. There was significant relation between the type of foreign body and age (p <0.05) and the living foreign body and ear. Conclusion: Foreign bodies of nose, ear and throat are common in ENT department. They should be timely managed to prevent potential complications.

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