Case Reports in Gastroenterology (Nov 2016)

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

  • Hironobu Mikami,
  • Norihisa Ishimura,
  • Akihiko Oka,
  • Ichiro Moriyama,
  • Takafumi Yuki,
  • Kousaku Kawashima,
  • Shuichi Sato,
  • Shunji Ishihara,
  • Yoshikazu Kinoshita

DOI
https://doi.org/10.1159/000452210
Journal volume & issue
Vol. 10, no. 3
pp. 646 – 652

Abstract

Read online

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.

Keywords