Rectal Foreign Bodies Workup

  • Author: David W Munter, MD, MBA; Chief Editor: Steven C Dronen, MD, FAAEM   more...
 
Updated: Oct 20, 2011
 

Laboratory Studies

Laboratory studies generally do not add much useful information in the acute presentation. A hematocrit may be useful if bleeding is present. Obtain a white blood cell (WBC) count with differential when infection is suspected.

For patients who are operative candidates (eg, patients who show signs of peritonitis, sepsis, or perforation or who have rectal foreign bodies that cannot be removed in the emergency department), obtain routine preoperative laboratory studies.

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Radiography

A flat plate radiograph of the abdomen or pelvis is indicated. The foreign object can be identified and localized in most cases (see the images below). A lateral pelvic film sometimes gives additional information regarding the orientation of the foreign body, particularly whether its position is high- or low-lying. An upright chest radiograph is indicated if perforation is suspected. If concerns arise about perforation or abscess, computed tomography is indicated.

Typical appearance of a vibrator in the rectum. Typical appearance of a vibrator in the rectum. Vibrator in the rectum. The patient attempted selfVibrator in the rectum. The patient attempted self-removal with a pair of salad tongs, which also became lodged, resulting in two rectal foreign bodies. Multiple attempts at self-removal are typical in patients with rectal foreign bodies.
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Contributor Information and Disclosures
Author

David W Munter, MD, MBA  Associate Clinical Professor of Emergency Medicine, Eastern Virginia Medical School; Associate Professor of Emergency Medicine, Edward Via Virginia College of Osteopathic Medicine; Medical Director, Emergency Medical Department, Sentara Obici Hospital; Partner, Emergency Physicians of Tidewater, PLC; President of the DESA Consulting Group

David W Munter, MD, MBA is a member of the following medical societies: American College of Emergency Physicians, American College of Physician Executives, Medical Society of Virginia, and Norfolk Academy of Medicine

Disclosure: Nothing to disclose.

Chief Editor

Steven C Dronen, MD, FAAEM  Chair, Department of Emergency Medicine, LeConte Medical Center

Steven C Dronen, MD, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine and Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Additional Contributors

Eugene Hardin, FAAEM, FACEP Former Chair and Associate Professor, Department of Emergency Medicine, Charles Drew University of Medicine and Science; Former Chair, Department of Emergency Medicine, Martin Luther King Jr/Drew Medical Center

Disclosure: Nothing to disclose.

Edmond A Hooker II, MD, DrPH, FAAEM Assistant Professor, Department of Emergency Medicine, University of Cincinnati College of Medicine

Edmond A Hooker II, MD, DrPH, FAAEM is a member of the following medical societies: American Academy of Emergency Medicine, American Public Health Association, Society for Academic Emergency Medicine, and Southern Medical Association

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

References

  1. Rosser C. Colonic foreign bodies. JAMA. 1929;39:368-369.

  2. Wagner J. Foreign bodies in the rectum. Am J Surg. 1937;36:266-269.

  3. Caliskan C, Makay O, Firat O, Can Karaca A, Akgun E, Korkut MA. Foreign bodies in the rectum: an analysis of 30 patients. Surg Today. Jun 2011;41(6):795-800. [Medline].

  4. Kurer MA, Davey C, Khan S, Chintapatla S. Colorectal foreign bodies: a systematic review. Colorectal Dis. Sep 2010;12(9):851-61. [Medline].

  5. Smith MT, Wong RK. Foreign bodies. Gastrointest Endosc Clin N Am. Apr 2007;17(2):361-82, vii. [Medline].

  6. Goldberg JE, Steele SR. Rectal foreign bodies. Surg Clin North Am. Feb 2010;90(1):173-84, Table of Contents. [Medline].

  7. Rodriguez-Hermosa JI, Codina-Cazador A, Ruiz B, Sirvent JM, Roig J, Farres R. Management of foreign bodies in the rectum. Colorectal Dis. Jul 2007;9(6):543-8. [Medline].

  8. Clarke DL, Buccimazza I, Anderson FA, Thomson SR. Colorectal foreign bodies. Colorectal Dis. Jan 2005;7(1):98-103. [Medline].

  9. Stack LB, Munter DW. Foreign bodies in the gastrointestinal tract. Emerg Med Clin North Am. Aug 1996;14(3):493-521. [Medline].

  10. Anderson KL, Dean AJ. Foreign bodies in the gastrointestinal tract and anorectal emergencies. Emerg Med Clin North Am. May 2011;29(2):369-400, ix. [Medline].

  11. Lake JP, Essani R, Petrone P, et al. Management of retained colorectal foreign bodies: predictors of operative intervention. Dis Colon Rectum. Oct 2004;47(10):1694-8. [Medline].

  12. Koornstra JJ, Weersma RK. Management of rectal foreign bodies: description of a new technique and clinical practice guidelines. World J Gastroenterol. Jul 21 2008;14(27):4403-6. [Medline]. [Full Text].

 
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Typical appearance of a vibrator in the rectum.
Vibrator in the rectum. The patient attempted self-removal with a pair of salad tongs, which also became lodged, resulting in two rectal foreign bodies. Multiple attempts at self-removal are typical in patients with rectal foreign bodies.
 
 
 
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