Liu Congcong, Li Yuantao
First Clinical Medical College, The Afffliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, China.
First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, China.
Medicine (Baltimore). 2024 Nov 22;103(47):e40651. doi: 10.1097/MD.0000000000040651.
Retained rectal foreign bodies (RFBs) are unusual clinical presentations whose management is challenging for emergency physicians owing to variations in the object types, anorectal anatomy, sacral curvature, insertion times, and local contamination. Here, we present the diagnosis and treatment in 1 case of retained rectal foreign body.
A 62-year-old male presented to the emergency department with a cosmetic bottle inserted into the rectum while bathing. He had difficulty defecating and denied any underlying psychiatric illness. Before coming to the hospital, the patient attempted to remove the cosmetic bottle with a screwdriver but failed, causing the cosmetic bottle to penetrate further into the intestinal lumen. The patient felt that the anal bulging was gradually worsening.
Investigations, a digital rectal examination, and coronal abdominal computed tomography revealed a foreign body stuck in the rectum.
After lateral internal sphincterotomy, the cosmetic bottle's plastic cap was pinched using a towel clamp and rotated slowly. The patient had an uneventful recovery period; the difficult defecation and anal bulging were relieved.
This case proves that lateral internal sphincterotomy can be performed to remove retained rectal foreign bodies if sufficient sphincter relaxation and anal dilatation cannot be achieved with proper anesthesia.
直肠异物残留（RFBs）是一种不常见的临床表现，由于异物类型、肛管直肠解剖结构、骶骨弯曲度、插入时间以及局部污染情况各不相同，其处理对急诊医生而言具有挑战性。在此，我们介绍1例直肠异物残留的诊断及治疗情况。
一名62岁男性在急诊就诊，其在洗澡时将一个化妆品瓶插入直肠。他排便困难，否认有任何潜在精神疾病。在来医院之前，患者试图用螺丝刀取出化妆品瓶，但未成功，导致化妆品瓶进一步刺入肠腔。患者感觉肛门坠胀逐渐加重。
通过直肠指检、冠状位腹部计算机断层扫描等检查发现直肠内有异物卡住。
行外侧内括约肌切开术后，用巾钳夹住化妆品瓶的塑料瓶盖并缓慢旋转。患者恢复过程顺利；排便困难及肛门坠胀症状缓解。
该病例证明，如果在适当麻醉下无法实现足够的括约肌松弛和肛门扩张，则可进行外侧内括约肌切开术以取出直肠异物残留。
