Obinwa Obinna, Robertson Ian, Stokes Maurice
Department of Surgery, Mater Misericordiae University Hospital, Eccles Street, Dublin, Ireland.
Consultant Surgeon and Senior Lecturer in Surgery, Mater Misericordiae University Hospital, Eccles Street, Dublin, Ireland.
Int J Surg Case Rep. 2015;15:96-8. doi: 10.1016/j.ijscr.2015.08.014. Epub 2015 Aug 14.
Phallic objects may cause large bowel obstruction if not promptly removed. A bi-manual technique with the aid of a Magill's forceps is presented here.
A 68-year-old man presented to the emergency department with severe lower abdominal discomfort, distension and inability to pass urine, flatus or bowel motions. He had inserted a phallic object in the rectum 10 hours prior to presentation and had been unable to remove same. Abdominal examination was remarkable for distension with tenderness also elicited suprapubically and in the left iliac fossa. The foreign body was barely palpable per rectum. Plain radiographs showed prominent left-sided colonic segments. Following the trial of a manual attempt at removal in the emergency department, a decision was made to remove this under anaesthesia due to worsening symptoms. The phallic object was successfully removed under general anaesthesia using bi-manual manipulation assisted by a pair of Magill's forceps.
The method of removal of phallic objects varies from one individual case to another. In the presence of obstruction, a quick decision must be made for removal under general anaesthesia and the patient will also need to be consented for laparotomy. Previous literature described a "cork-in-bottle" technique using myomectomy screws as well as use of single-incision laparoscopic surgery (SILS) ports for removal of phallic objects.
Extraction of phallic objects requires ingenuity. We describe another minimally invasive technique of removal that adds to the literature, thereby limiting the need for laparotomy and open removal of foreign bodies.
阴茎状物体若不及时取出，可能导致大肠梗阻。本文介绍一种借助麦吉尔氏钳的双手操作技术。
一名68岁男性因严重下腹部不适、腹胀且无法排尿、排气或排便，前往急诊科就诊。他在就诊前10小时将一个阴茎状物体插入直肠，且无法自行取出。腹部检查发现腹胀明显，耻骨上及左髂窝有压痛。经直肠几乎触不到异物。腹部平片显示左侧结肠段明显扩张。在急诊科尝试手动取出失败后，鉴于症状恶化，决定在麻醉下取出异物。在全身麻醉下，借助麦吉尔氏钳进行双手操作，成功取出了阴茎状物体。
阴茎状物体的取出方法因具体病例而异。若存在梗阻，必须迅速决定在全身麻醉下取出，且还需征得患者同意进行剖腹手术。既往文献描述了使用子宫肌瘤切除螺钉的“瓶中软木塞”技术以及使用单切口腹腔镜手术（SILS）端口取出阴茎状物体的方法。
取出阴茎状物体需要技巧。我们描述了另一种微创取出技术，丰富了相关文献，从而减少了剖腹手术和开放性异物取出的必要性。
