Rectal foreign bodies (RFBs) have been documented in medical literature for centuries, with one of the earliest recorded cases dating to the 16th century. In modern clinical practice, RFB presentations are increasingly observed in emergency departments, particularly in urban settings. Reported cases of RFBs span a wide age range from infancy to over 90 years, with most adult patients being male. Among male patients, presentations show a bimodal age distribution with a prominent peak in the 40s, while female patients tend to present at younger ages. Emergency department visits involving older men have also shown a marked increase in recent years. Despite this rising incidence, no universal clinical guidelines currently exist to standardize management, leading to wide variation in practice. Glass bottles are the most frequently reported RFBs, accounting for approximately 42.2% of cases. Other materials that have reportedly been recovered include sex toys, household objects, fruits and vegetables, aerosol cans, lightbulbs, tools, and drug packets. Motivations for rectal insertion include sexual gratification, concealment in the context of body packing, and sexual assault. In some cases, foreign body insertion may result from accidental events. Autoeroticism remains the most common underlying factor, paralleling a growing trend in the use of nonmedical objects for anal sexual activity. The timing of presentation varies widely. Some individuals seek immediate emergency care due to significant discomfort or inability to retrieve the object, while others delay for several days or even weeks, often because of embarrassment or other psychosocial barriers. In some cases, patients may attempt self-extraction before obtaining medical attention, which not only delays appropriate management but may also increase the risk of mucosal injury or deeper impaction. Upon arrival at the emergency department, many patients hesitate to disclose the true cause of their symptoms and, instead, report nonspecific complaints such as rectal bleeding, pain, or constipation, further contributing to delays in recognition and treatment. RFB retention constitutes an emergency because of the risk of serious complications, including rectal or colonic perforation, hemorrhage, bowel obstruction, mucosal necrosis, and infection. Delayed recognition or removal increases the likelihood of these outcomes and may result in surgical intervention or sepsis. Advancements in medical technology have expanded the available methods for RFB removal to include minimally invasive surgical options such as endoscopy and laparoscopy. However, emergency medicine physicians must be prepared to evaluate and manage RFBs nonoperatively, as timely intervention can prevent the need for surgery and its associated risks. With proper technique and preparation, many cases can be safely and effectively managed in the emergency department, minimizing long-term complications.
直肠异物（RFBs）在医学文献中已有数百年的记载，最早有记录的病例之一可追溯到16世纪。在现代临床实践中，急诊科越来越多地观察到直肠异物病例，尤其是在城市环境中。报道的直肠异物病例年龄跨度很大，从婴儿期到90多岁，大多数成年患者为男性。在男性患者中，发病呈双峰年龄分布，40多岁时有一个明显的高峰，而女性患者往往发病年龄较小。近年来，涉及老年男性的急诊科就诊人数也显著增加。尽管发病率不断上升，但目前尚无统一的临床指南来规范治疗，导致治疗方法差异很大。玻璃瓶是最常报道的直肠异物，约占病例的42.2%。据报道，其他已取出的物品包括性玩具、家居用品、水果和蔬菜、气雾剂罐、灯泡、工具和毒品包装。直肠插入的动机包括性满足、在人体藏毒背景下的隐匿以及性侵犯。在某些情况下，异物插入可能是意外事件导致的。自体性行为仍然是最常见的潜在因素，这与将非医疗物品用于肛交的趋势不断增加相平行。就诊时间差异很大。一些人因严重不适或无法取出异物而立即寻求急诊治疗，而另一些人则拖延数天甚至数周，通常是因为尴尬或其他社会心理障碍。在某些情况下，患者在就医前可能会尝试自行取出异物，这不仅会延迟适当的治疗，还可能增加黏膜损伤或更深嵌顿的风险。到达急诊科后，许多患者不愿透露症状的真正原因，而是报告直肠出血、疼痛或便秘等非特异性症状，这进一步导致识别和治疗的延迟。由于存在严重并发症的风险，包括直肠或结肠穿孔、出血、肠梗阻、黏膜坏死和感染，直肠异物滞留构成紧急情况。识别或取出延迟会增加这些后果的可能性，并可能导致手术干预或败血症。医学技术的进步扩大了直肠异物取出的可用方法，包括内镜检查和腹腔镜检查等微创手术选择。然而，急诊医学医生必须准备好对直肠异物进行非手术评估和处理，因为及时干预可以避免手术及其相关风险。通过适当的技术和准备，许多病例可以在急诊科安全有效地得到处理，将长期并发症降至最低。
