Mikami Hironobu, Ishimura Norihisa, Oka Akihiko, Moriyama Ichiro, Yuki Takafumi, Kawashima Kousaku, Sato Shuichi, Ishihara Shunji, Kinoshita Yoshikazu
Department of Gastroenterology and Hepatology, Shimane University School of Medicine, Izumo, Japan.
Cancer Center, Shimane University Hospital, Izumo, Japan.
Case Rep Gastroenterol. 2016 Nov 7;10(3):646-652. doi: 10.1159/000452210. eCollection 2016 Sep-Dec.
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.
我们偶尔会遇到患有各种类型直肠异物的患者。当异物太大无法抓取时，经肛门取出可能会很困难。在此，我们报告一例成功经肛门手动取出一根18×4×4厘米硅棒且无并发症的病例。一名50岁男性在经肛门插入一整根硅棒12小时后前来我院急诊科。腹部检查未发现腹膜炎迹象，而X线和计算机断层扫描结果显示直肠内有一个大的异物，没有任何穿孔迹象。起初，我们尝试使用包括圈套器和抓钳在内的传统内镜器械通过内镜手术取出，但由于异物尺寸较大而失败。接下来，我们在内镜和X线荧光透视观察下从腹壁手动挤压异物，并成功经肛门取出，无并发症。在这种情况下，内镜和X线荧光透视辅助有助于指导腹部挤压的方向和角度。
