Robinson Elizabeth C, Roy David, Driver Brian E
Department of Emergency Medicine, Hennepin County Medical Center, Minneapolis, Minnesota.
J Emerg Med. 2018 Feb;54(2):e23-e25. doi: 10.1016/j.jemermed.2017.10.015. Epub 2017 Nov 24.
Rectal foreign bodies are commonly encountered in the emergency department (ED). Three techniques are well described in literature, including using a Foley catheter, "scooping" the object out, or grasping the object directly with ring forceps. We present a novel extraction method for an inflatable foreign body.
A 27-year-old man presented to the ED 13 h after inserting a rubber inflatable child's ball into his rectum. After well-described extraction techniques failed to remove the ball, an 18-gauge needle at the end of a syringe was inserted into the rectum to puncture the ball and partially deflate it. The ball was then able to be removed easily. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: Although recent published literature has pushed for early consultation of surgical specialties in lieu of emergency physician bedside extraction, this case report highlights the ability of emergency physicians to modify known extraction techniques to safely remove rectal foreign bodies in well-appearing patients at the bedside using appropriate analgesia, positioning, and readily available equipment.
直肠异物在急诊科很常见。文献中详细描述了三种取出技术，包括使用 Foley 导管、将异物“舀出”或直接用环形镊子抓取异物。我们介绍一种针对可充气异物的新型取出方法。
一名 27 岁男性在将一个橡胶充气儿童球插入直肠 13 小时后就诊于急诊科。在采用上述详细描述的取出技术未能取出球状物后，将连接在注射器末端的 18 号针头插入直肠，刺破球状物并使其部分放气。然后该球状物能够轻松取出。急诊医生为何应知晓此事？：尽管最近发表的文献主张早期请外科专科会诊，而不是由急诊医生在床边取出异物，但本病例报告强调了急诊医生有能力通过使用适当的镇痛、体位和现成设备，对已知的取出技术进行改进，从而在床边安全地为病情表现良好的患者取出直肠异物。
