Rectal foreign bodies: Case reports and a comprehensive review of the world's literature
D.B. Busch, Ph.D., M.D., and J.R. Starling, M.D.
in the journal Surgery, 1986.
The surgical management of two patients presenting with incarcerated, apparently self-inserted foreign bodies is reported. The large volume of prior literature on this subject is reviewed, with a tabluation of 182 previous cases by type and number of objects recovered and with a discussion of patients' age distribution, history, complications, and prognosis. Management problems addressed include history, differential diagnosis of reported pruitis ani, and handling of suspected assault.
A 39-year-old married white male lawyer presented with a self-inserted perfume bottle in his rectum that he was unable to remove using various objects, including a back scratcher. He had inserted this bottle on previous occasions. Edema of the rectum and sigmoid colon precluded the successful manual removal of the object in the emergency room. ... The 3 by 17 cm object, "Impulse Body Spray," was removed manually after a spinal anesthetic.
Table I. Previously reported recovered foreign bodies
Glass or ceramic Bottle or jar 31 Bottle with attached rope 1 Glass or cup 12 Light bulb 7 Tube 6 Total 57
Food Apple 1 Banana 2 Carrot 4 Cucumber 3 Onion 2 Parsnip 1 Plantain (with condom) 1 Potato 1 Salami 1 Turnip 1 Zucchini 2 Total 19
Wooden Ax handle 1 Stick or broom handle 10 Miscellaneous or unspecified 3 Total 14
Sexual device Vibrator 23 Dildo 15 Total 38
Kitchen device Dull knife* 1 Ice pick 1 Knife sharpener 1 Mortar pestle 2 Spatula (plastic) 1 Spoon 1 Tin cup 1 Total 8
Miscellaneous tools Candle 1 Flashlight 2 Iron rod 1 Pen 2 Rubber tube 1 Screwdriver 1 Toothbrush 1 Wire spring 1 Total 10
Inflated device Balloon 1 Balloon attached to cylinder 1 Condom 1 Total 3
Ball Baseball 2 Tennis ball 1 Total 3
Miscellaneous containers Baby powder can 1 Candle box 1 Snuff box 1 Total 3
Miscellaneous Bottle cap** 1 Cattle horn 3 Frozen pig's tail 1 "Kangaroo tumor"*** 1 Plastic rod 1 Stone 2 Toothbrush holder 1 Toothbrush package 1 Whip handle 2 Total 13
Grand total 168 cases
Collections (one case of each) 2 Glass tubes 72 1/2 Jeweler's saw**** Oil can with potato stopper Piece of wood, peanut** Umbrella handle and enema tubing 2 Glasses Phosphorous matchends (homicide) 402 Stones Toolbox***** 2 Bars soap Beer glass and preserving pot Lemon and cold cream jar 2 Apples Spectacles, suitcase key, tobacco pouch, and magazine Total 14 collection, with approximately 500 objects
* Patient complained of "knife-like pain" ** Cannot exclude ingestion *** Unique case of pedunculated perianal skin tumor habitually inserted into rectum **** Multiple episodes of perirectal self-insertion ***** Inside a convict; contained saws and other items usable in escape attempts
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