Singaporewalla Reyaz M, Tan Daniel E L, Tan Teng K
Department of Surgery, Alexandra Hospital, Singapore.
Surg Laparosc Endosc Percutan Tech. 2007 Apr;17(2):145-8. doi: 10.1097/SLE.0b013e318045bf1a.
Rectal foreign bodies are common and various shapes and sizes have been described in literature. Large objects impacted high in the rectosigmoid junction pose a challenge for endoscopic extraction. We describe a method that successfully removed a 15x6x3.5-cm shampoo bottle impacted in the rectosigmoid junction. A 50-year-old man had passed a shampoo bottle up into his rectum. Examination revealed a lax sphincter but the bottle could not be felt. Contrast x-rays showed a well-delineated bottle in the rectosigmoid junction with no evidence of bowel perforation. A flexible sigmoidoscope with an endoscopic snare was used to "lasso" the foreign body and deliver it out. A check sigmoidoscopy after extraction showed no bleeding or perforation. This technique is a safer and less morbid method of extracting impacted high rectal foreign bodies, in the absence of perforation. It should be attempted before open surgical removal.
直肠异物很常见，文献中描述了其各种形状和大小。位于直肠乙状结肠交界处高位的大型异物给内镜下取出带来挑战。我们描述了一种成功取出卡在直肠乙状结肠交界处的一个15×6×3.5厘米洗发水瓶的方法。一名50岁男性将一个洗发水瓶塞入直肠。检查发现括约肌松弛，但摸不到瓶子。造影X线显示直肠乙状结肠交界处有一个轮廓清晰的瓶子，无肠穿孔迹象。使用带有内镜圈套器的可弯曲乙状结肠镜“套住”异物并将其取出。取出后复查乙状结肠镜检查显示无出血或穿孔。在没有穿孔的情况下，该技术是取出高位嵌顿直肠异物更安全、并发症更少的方法。在进行开放性手术取出之前应尝试使用该方法。
