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Foreign Body, Rectal, Emergency Medicine

Joanna W. Davidson Reviewed 06/2017
 


Basics

Description

  • Self-insertion (autoeroticism):

    • Phallic substitutes inserted by patient or partner

    • Usually men aged 20–40 yr, with male to female ratio 20:1

  • Ingested objects lodged in rectum:

    • Chicken bo...

Diagnosis

Signs and Symptoms

  • Complaint of rectal FB

  • Rectal fullness

  • Rectal pain

  • Perirectal abscess (with imbedded bones/toothpick)

  • FB on rectal exam:

    • High-lying FBs are located proximal to rectosigmoid junc...

Treatment

Pre-Hospital

Cautions: 
  • Patient has usually tried to remove FB and failed.

  • Further attempts at extraction will not work and could cause perforation.

Initial Stabilization/Therapy

  • Perforation with...

Follow-Up

Disposition

Admission Criteria

  • Failed extraction in ED requires surgical removal in the operating room.

  • Evidence of mucosal tear on proctoscopy should be observed for 24 hr (no antibiotic indic...

Pearls and Pitfalls

  • Passage of Foley catheter beyond object with insufflation of air breaks vacuum and permits retrieval.

  • Provide adequate sedation/analgesia when attempting FB removal in the ED.

Additional Reading

  • Clarke  DL, Buccimazza  I, Anderson  FA, et al. Colorectal foreign bodies. Colorectal Dis.  2005;7:98–103.

  • Coskun  A, Erkan  N, Yakan  S, et al. Management of rectal foreign bod...

Codes

ICD9

937 Foreign body in anus and rectum 

ICD10

T18.5XXA Foreign body in anus and rectum, initial encounter 

SNOMED

  • 70176004 foreign body in rectum (disorder)

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