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一名学龄儿童经肛门直肠异物的处理:1例罕见病例报告

Management of Transanal Recto-Anal Foreign Body in a School-Aged Child: A Report of a Rare Case.

作者信息

Iwai Takuma, Yoshida Hiroshi

机构信息

Gastroenterological Surgery, Nippon Medical School, Tokyo, JPN.

出版信息

Cureus. 2024 Nov 6;16(11):e73120. doi: 10.7759/cureus.73120. eCollection 2024 Nov.

DOI:10.7759/cureus.73120
PMID:39650898
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11622728/
Abstract

Transrectal recto-anal foreign bodies are occasionally encountered in routine practice, with sexual experimentation as the most common motivation for insertion. Although most patients with recto-anal foreign bodies are middle-aged, reports in younger patients are rare. In the present study, we encountered a case of recto-anal foreign body in a school-aged child. This report highlights some unique precautions for managing such cases in this population. The patient, a 12-year-old male, was referred to our department after a lip balm was inserted transanally, causing persistent discomfort. The patient exhibited no spontaneous abdominal pain or tenderness. The motive for inserting the foreign body was sexual interest. An abdominopelvic CT scan showed a foreign body that had entered the upper rectum. Lumbar anesthesia was administered, and the patient was positioned in the lithotomy position. Under a lower endoscope, one end of the foreign body was grasped with forceps and withdrawn into the lower rectum. The foreign body was removed with the assistance of an assistant performing anal dilatation. The patient was discharged the next day after confirming the absence of complications. Managing recto-anal foreign bodies in younger patients requires specific considerations, such as gentle handling to avoid damage due to stronger anorectal tonus. Moreover, it is crucial to assess potential social or psychological factors, including the possibility of abuse or bullying, that may underlie the insertion of the foreign body.

摘要

经直肠的直肠肛门异物在常规诊疗中偶尔会遇到,其中性实验是最常见的插入动机。虽然大多数直肠肛门异物患者为中年,但关于年轻患者的报道很少。在本研究中,我们遇到了一例学龄儿童直肠肛门异物病例。本报告强调了在该人群中处理此类病例的一些独特注意事项。患者为一名12岁男性,在经肛门插入一支润唇膏后出现持续不适,随后被转诊至我科。患者无自发腹痛或压痛。插入异物的动机是性兴趣。腹部盆腔CT扫描显示异物已进入直肠上段。给予腰麻,患者取截石位。在低位内镜下,用钳子抓住异物一端并将其拉至直肠下段。在一名助手进行肛门扩张的协助下取出异物。确认无并发症后,患者于次日出院。处理年轻患者的直肠肛门异物需要特殊考虑,例如轻柔操作以避免因更强的肛门直肠张力而造成损伤。此外,评估潜在的社会或心理因素至关重要,包括可能是异物插入背后原因的虐待或欺凌可能性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9196/11622728/b8bc4f82e873/cureus-0016-00000073120-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9196/11622728/2e9b8218ae60/cureus-0016-00000073120-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9196/11622728/b8bc4f82e873/cureus-0016-00000073120-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9196/11622728/2e9b8218ae60/cureus-0016-00000073120-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9196/11622728/b8bc4f82e873/cureus-0016-00000073120-i02.jpg

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