Sheets Nicholas W, Waldrop Ian, Carpenter William C, Dubina Emily, Kondal Bhani, Schultz Hayden, Plurad David
Trauma and Acute Care Surgery, Riverside Community Hospital, Riverside, USA.
Cureus. 2023 Jul 6;15(7):e41471. doi: 10.7759/cureus.41471. eCollection 2023 Jul.
Introduction Rectal foreign bodies may result in significant morbidity, potentially necessitating surgical intervention and ostomy creation. The sensitive nature of the diagnosis may lead to inaccurate patient history and possible delay in diagnosis. Currently, there is a paucity of large national studies addressing this diagnosis. Therefore, we present national data describing the demographics and incidence of patients presenting with rectal foreign bodies. Methods The National Electronic Injury Surveillance System (NEISS) was utilized to collect data regarding rectal foreign bodies. Ten years of data were collected from 2012 to 2021. Inclusion criteria focused on the diagnosis of "foreign body" coupled with pelvic and lower torso injuries. Exclusion criteria encompassed patients without a rectal foreign body clearly identified in the narrative. Patients were compared based on disposition as low severity (treated/examined and released or left without being seen) or high severity (treated and admitted/hospitalized, held for observation, or transferred to another facility). General descriptive and inferential analyses were performed regarding demographics and dispositions. Results A total of 1,806 emergency department (ED) visits were identified for inclusion. Patients ranged in age from 0 to 93 years, with a mean age of 30 years. The largest age group identified was 11-15 and 21-25 years. Most patients were male (64.6%) and white (47.1%). The most common foreign bodies were massage devices and vibrators (22.7%), jewelry (8.1%), pens and pencils (4.4%), fishing gears (activity, apparel, or equipment) (3.7%), and nonglass bottles or jars (2.6%). Patients requiring admission, observation, or transfer differed from those patients that were discharged from the ED by age, sex, race, and product involved. Discussion Rectal foreign bodies are a rare diagnosis with a growing incidence. Though the most common objects are massage devices and vibrators consistent with sexual stimulation devices, there are limited product guidelines for safe use. Further studies to help identify at-risk persons, safety precautions, and manufacturing guidelines may help prevent potential morbidity associated with rectal foreign bodies.
引言 直肠异物可能导致严重的发病情况,可能需要进行手术干预并造口。诊断的敏感性可能导致患者病史不准确,进而可能延误诊断。目前,缺乏针对这一诊断的大型全国性研究。因此,我们呈现描述直肠异物患者人口统计学特征和发病率的全国性数据。方法 利用国家电子伤害监测系统(NEISS)收集有关直肠异物的数据。收集了2012年至2021年的十年数据。纳入标准侧重于“异物”诊断以及骨盆和下半身损伤。排除标准包括在叙述中未明确识别出直肠异物的患者。根据处置情况将患者分为低严重程度(接受治疗/检查并出院或未就诊离开)或高严重程度(接受治疗并入院/住院、留院观察或转至另一机构)进行比较。对人口统计学特征和处置情况进行了一般描述性和推断性分析。结果 共确定1806例符合纳入标准的急诊就诊病例。患者年龄从0岁至93岁不等,平均年龄为30岁。确定的最大年龄组为11 - 15岁和21 - 25岁。大多数患者为男性(64.6%)且为白人(47.1%)。最常见的异物是按摩器具和振动器(22.7%)、首饰(8.1%)、钢笔和铅笔(4.4%)、渔具(活动、服装或设备)(3.7%)以及非玻璃瓶罐(2.6%)。需要入院、观察或转院的患者在年龄、性别、种族和所涉及产品方面与从急诊出院的患者不同。讨论 直肠异物是一种罕见诊断,但发病率在上升。尽管最常见的物品是与性刺激装置一致的按摩器具和振动器,但安全使用的产品指南有限。有助于识别高危人群、安全预防措施和制造指南的进一步研究可能有助于预防与直肠异物相关的潜在发病情况。