Ikram Saad, Singh Shailendra, Kallam Ramana, Dabra Ajay
General Surgery, Northern Lincolnshire and Goole Hospitals NHS Foundation Trust, Scunthorpe, UK.
Colorectal Surgery, Northern Lincolnshire and Goole Hospitals NHS Foundation Trust, Scunthorpe, UK.
BMJ Case Rep. 2017 Dec 13;2017:bcr-2017-222959. doi: 10.1136/bcr-2017-222959.
Colorectal foreign bodies (FBs) are not unheard of in the province of surgery. They are commonly seen in men ranging from 20 to 90 years of age with a bimodal age distribution. A variety of objects have been described and reported in literature. Management involves a complete history and examination followed by the necessary investigations. Most of the time they can be removed at bedside with some manipulation techniques employing the use of some ingenious devices and/or endoscopy for adamant objects. But persistent FBs or those that are high in the rectum or those that present with complications will require operative management. We present a case of a 77 cm long FB inserted rectally for sexual gratification in a male patient, which caused a large bowel perforation, ending high intra-abdominally at the level of the spleen and diaphragm after traversing the entire abdominal cavity and requiring a laparotomy for removal.
结直肠异物在外科领域并非闻所未闻。它们常见于20至90岁的男性，年龄分布呈双峰型。文献中描述和报道了各种各样的异物。处理方法包括全面的病史询问和体格检查，随后进行必要的检查。大多数情况下，通过一些巧妙的操作技术，使用一些精巧的器械和/或内镜，就可以在床边取出异物。但对于持续存在的异物、直肠高位异物或出现并发症的异物，则需要手术处理。我们报告一例男性患者，为满足性快感经直肠插入了一根77厘米长的异物，该异物导致大肠穿孔，在穿过整个腹腔后，在脾脏和膈肌水平高位进入腹腔，需要开腹取出。
