Martínez-Hincapie Cristina Isabel, González-Arroyave Daniel, Ardila Carlos M
Department of Surgery, Pontificia Universidad Bolivariana, Medellín 050031, Antioquia, Colombia.
Department of Basic Sciences, Faculty of Dentistry Universidad de Antioquia, Medellin 0057, Antioquia, Colombia.
World J Clin Cases. 2025 Jun 26;13(18):103438. doi: 10.12998/wjcc.v13.i18.103438.
Rectal foreign bodies, though uncommon, present diagnostic and therapeutic challenges, particularly when they result from accidental ingestion. The nonspecific symptoms and the potential for serious complications necessitate a thorough and methodical approach to diagnosis and treatment. This case report aims to highlight the diagnostic complexities and management strategies involved in treating a patient with a rectal foreign body, focusing on the use of advanced imaging techniques and the importance of a multidisciplinary approach.
A 48-year-old male with a history of hypertension presented with a one-year history of post-defecation anorectal pain and mild post-defecation rectorrhagia. Initial evaluation revealed hemodynamic stability and a tender, non-mucosal lesion in the anterior left rectal region. Imaging studies, including colonoscopy, magnetic resonance imaging, and endosonography, identified an erythematous, exophytic lesion and a perirectal abscess containing a foreign body. Surgical intervention revealed necrotic tissue and purulent material, along with two solid foreign body fragments (bone or plant matter). Postoperative follow-up showed the patient in good condition, and pathology confirmed the fragments as mature bone.
This case underscores the diagnostic challenges posed by rectal foreign bodies with nonspecific symptoms and no clear history of ingestion.
直肠异物虽不常见,但会带来诊断和治疗方面的挑战,尤其是在因意外摄入导致的情况下。非特异性症状以及严重并发症的可能性使得诊断和治疗需要采取全面且有条不紊的方法。本病例报告旨在突出治疗直肠异物患者时所涉及的诊断复杂性和管理策略,重点关注先进成像技术的应用以及多学科方法的重要性。
一名有高血压病史的48岁男性,出现排便后肛门直肠疼痛1年及轻度排便后直肠出血。初步评估显示血流动力学稳定,直肠左前区域有一个压痛、非黏膜性病变。包括结肠镜检查、磁共振成像和内镜超声在内的影像学检查发现一个红斑样、外生性病变以及一个含有异物的直肠周围脓肿。手术干预发现坏死组织和脓性物质,还有两个固体异物碎片(骨头或植物物质)。术后随访显示患者状况良好,病理证实碎片为成熟骨。
本病例强调了具有非特异性症状且无明确摄入史的直肠异物所带来的诊断挑战。