Rectal perforation caused by a self-inserted foreign body: a case report

Rectal foreign bodies have a storied history as a part of anorectal trauma. Objects encountered are most commonly household objects consisting of bottles and glasses. Other objects include tooth brushes, deodorant bottles, food articles, knives, sports equipment, cell phones, flash lights, wooden rods, broom sticks, sex toys including dildos and vibrators, light bulbs, nails, or other construction tools, christmas ornaments, aerosol canisters, cocaine packets, and many more. The reasons for insertion in decreasing order of frequency are autoeroticism, concealment, attention-seeking behavior, accidental, assault and to alleviate constipation. Here we presented a case of 32 years old presented to the ER with complaints of pain in lower abdomen and anal region for 12 hours. He complained of severe pain when he tried to defecate. He gave history of self-insertion of an empty drug vial into his rectum. Rectal foreign bodies represent a challenging and unique field of colorectal trauma. The important factors in dealing with these patients are careful history and physical examination. Patients are often embarrassed about this condition and may conceal the truth. So, a high index of suspicion is required to accurately diagnose.

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

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.

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

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.

COVID-19 and psychiatric illness: rectal foreign bodies (30 stylus batteries) in a young male patient affected by Asperger syndrome

Here we present the case of a 17-year-old male patient, affected by Asperger syndrome, who reached the emergency division of our hospital after anal insertion of some stylus batteries. Transanal extraction of 30 stylus batteries avoided surgical intervention. Lockdown and boredom due to the strict domestic quarantine policies adopted during COVID-19 pandemic might have unmasked in our patient a susceptibility to unhealthy behaviour.