Glass bottle in the rectum

Case Report

A 52 year old male patient contacted emergency services with abdominal and anal pain that had gradually increased over nearly 6 hours. Detailed medical history of patient revealed that he had inserted a foreign object into rectum and that he had occasionally done so to achieve sexual satisfaction over period of nearly 2 years. Patient stated that he had placed glass mineral water bottle in a glove and covered it with lubricating gel before inserting it into his rectum, but this time he couldn’t remove it. On physical examination, abdomen was relaxed and natural. Complete blood cell count (CBC) and biochemical parameters were within normal range. On digital rectal examination, base of bottle was palpated as solid object 5-6 cm proximal to anus. Standing abdominal radiographs of patient were obtained in emergency department for differential diagnosis, and showed bottle in the rectum without any evidence of free air or air-fluid levels. (Figure 1).

FIGURE 1
Intrarectal glass bottle detected on erect abdominal radiograph of Case 1.

Anal canal was dilated under sedation anesthesia; however, foreign body could not be extracted. Retroscopy under general anesthesia revealed base of bottle had completely occluded the lumen, and procedure was unsuccessful. Infraumbilical incision was performed and during exploration, foreign object was palpated in the colon. Manual effort to eject object from the outside also failed. Colotomy was then performed, and bottle was extracted in its entirety and without breakage (Figure 2). Colon was closed and there was no indication of intra-abdominal fluid or perforation. Postoperative period was uneventful. Psychiatric consultation and follow-up at outpatient clinics of psychiatry and general surgery were recommended prior to hospital discharge.

FIGURE 2
Surgically extracted rectal foreign object seen in Figure 1.
Author

1Department of General Surgery, Dumlupinar University Faculty of Medicine, Kutahya, Turkey2Department of General Surgery, Evliya Celebi Training and Research Hospital, Kutahya, Turkey3Department of General Surgery, Bahcelievler State Hospital, Istanbul, TurkeyCorrespondence: Dr. Sezgin ZEREN. Dumlupinar Universitesi Tip Fakultesi, Genel Cerrahi Anabilim Dali, Evliya Celebi Yerleskesi, Tavsanli Yolu 10. km, 43100 Kutahya, Turkey. Tel: +90 274 – 265 22 86 e-mail: moc.liamg@nereznigzes

References

1. Cologne KG, Ault GT. Rectal foreign bodies:what is the current standard? Clin Colon Rectal Surg. 2012;25:214–8. [PMC free article] [PubMed] [Google Scholar]2. Buluş H, Aydın A, Koyuncu A, Sugüneş T, Akpınar A, Coşkun A. Case of unusual foreign body in the rectum. Turk J Colorectal Dis. 2010;20:185–7. [Google Scholar]3. Thomas VP. A rare case of penetrating rectal injury. Indian J Surg. 2013;75:242–4. [PMC free article] [PubMed] [Google Scholar]4. Caliskan C, Makay O, Firat O, Can Karaca A, Akgun E, Korkut MA. Foreign bodies in the rectum:an analysis of 30 patients. Surg Today. 2011;41:795–800. [PubMed] [Google Scholar]5. Anderson KL, Dean AJ. Foreign bodies in the gastrointestinal tract and anorectal emergencies. Emerg Med Clin North Am. 2011;29:369–400. [PubMed] [Google Scholar]6. Elias B, Debs T, Hage S, Bassile B, Hanna P, Saint Eve P. Single incision laparoscopic surgery technique for transanal removal of rectal foreign body. J Surg Case Rep. 2014;20:1–3. [PMC free article] [PubMed] [Google Scholar]7. Yılmaz B, Ozmete S, Altınbas A, Aktaş B, Ekiz F. Successful removal of an unusual rectal foreign body with a Kocher clamp. Endoscopy. 2014;46(Suppl 1):UCTN–E549. [PubMed] [Google Scholar]8. Şahin A, Çapa T, Javadi M. Rektal yabancıcisimler. Kolon Rektum HastalıklarıDergisi. 1995;5:12–4. [Google Scholar]9. Yıldız İ, Yıldız İ, Yıldız ÖÖ, Bayır H, Genç A. Evolving with chicken bones Partial Airway Obstruction:A Case Repor. Abant Medical Journal. 2015;4:290–2. [Google Scholar]

Share it
Auto closing in 2 seconds
Auto closing in 2 seconds