eMedicine Specialties > Clinical Procedures > Gastrointestinal Procedures

Foreign Body Removal, Rectum

Author: Victoria L Hogan, MD, Assistant Professor, Department of Emergency Medicine, University of Alabama at Birmingham
Coauthor(s): Andrew R Edwards, MD, Assistant Professor of Emergency Medicine, Residency Program Director, Department of Emergency Medicine, University of Alabama at Birmingham; Co-Director, Department of Resuscitation, University of Alabama at Birmingham Hospital; Medical Director of Jefferson County SWAT Team, Jefferson County Sheriff's Department
Contributor Information and Disclosures

Updated: Mar 29, 2009

Introduction

Anorectal foreign bodies are usually inserted transanally for sexual or medicinal purposes. Rectal foreign bodies may also be observed with body packing/stuffing or after prior oral ingestion of the object. Anorectal foreign bodies are more common in men than in women.

Rectal foreign bodies may include such objects as bottles, vibrators, fruit, vegetables, and balls. Cylindrical objects are common. In addition, thermometers may accidentally break while a rectal temperature is being obtained.

Be aware that patients have usually made multiple attempts to remove the object prior to presentation in the emergency department. Patients may create unusual stories to explain how the object became lodged in the rectum.

Indications

Indications for bedside rectal foreign body removal in the emergency department include the following:

  • Object palpable on digital rectal examination
  • Object less than 10 cm proximal to the anal verge

Contraindications

Relative contraindications to bedside rectal foreign body removal in the emergency department include the following:

  • Severe abdominal pain
  • Object not palpable on digital rectal examination
  • Object more than 10 cm proximal to the anal verge
  • Broken glass present in the anus or rectum
  • Fragile object (eg, light bulb) present
  • Extended time since insertion
  • Inexperienced clinician
  • Uncooperative patient
Absolute contraindications to bedside rectal foreign body removal in the emergency department include the following:

  • Peritonitis
  • Perforation

More on Foreign Body Removal, Rectum

Overview: Foreign Body Removal, Rectum
Treatment & Medication: Foreign Body Removal, Rectum
Multimedia: Foreign Body Removal, Rectum
References
Further Reading
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References

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

  2. Lake JP, Essani R, Petrone P, Kaiser AM, Asensio J, Beart RW Jr. Management of retained colorectal foreign bodies: predictors of operative intervention. Dis Colon Rectum. Oct 2004;47(10):1694-8. [Medline].

  3. Management of rectal foreign bodies. In: Roberts JR, Hedges JR. Clinical Procedures in Emergency Medicine. 4th. Philadelphia, PA: WB Saunders Company; 2004:875-7.

  4. Hellinger MD. Anal trauma and foreign bodies. Surg Clin North Am. Dec 2002;82(6):1253-60. [Medline].

  5. 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].

  6. Management of specific anorectal problems. In: Marx JA, Hockberger RS, Walls RM. Rosen's Emergency Medicine: Concepts and Clinical Practice. 5th. St Louis, MO: Mosby; 2002:1356-1358.

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Further Reading

National Center for Emergency Medicine Informatics: Rectal Foreign Body

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Keywords

rectal foreign body, object in rectum, gastrointestinal tract, GI tract, foreign body, anus, anal foreign body, rectum, digital rectal examination, DRE, foreign body removal

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Contributor Information and Disclosures

Author

Victoria L Hogan, MD, Assistant Professor, Department of Emergency Medicine, University of Alabama at Birmingham
Victoria L Hogan, MD is a member of the following medical societies: American College of Emergency Physicians, American Medical Association, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Coauthor(s)

Andrew R Edwards, MD, Assistant Professor of Emergency Medicine, Residency Program Director, Department of Emergency Medicine, University of Alabama at Birmingham; Co-Director, Department of Resuscitation, University of Alabama at Birmingham Hospital; Medical Director of Jefferson County SWAT Team, Jefferson County Sheriff's Department
Andrew R Edwards, MD is a member of the following medical societies: American College of Physicians, Society for Academic Emergency Medicine, and Wilderness Medical Society
Disclosure: Nothing to disclose.

Medical Editor

Andrew K Chang, MD, Associate Professor, Department of Emergency Medicine, Albert Einstein College of Medicine, Montefiore Medical Center
Andrew K Chang, MD is a member of the following medical societies: American Academy of Emergency Medicine, American Academy of Neurology, American College of Emergency Physicians, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

Pharmacy Editor

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine
Disclosure: Pfizer Inc Stock Investment from financial planner; Avanir Pharma Stock Investment from financial planner ; WebMD Salary and stock Employment and investment from financial planner

Managing Editor

Luis M Lovato, MD, Associate Clinical Professor, David Geffen School of Medicine at UCLA; Director of Critical Care, Department of Emergency Medicine, Olive View/UCLA Medical Center
Luis M Lovato, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Emergency Physicians, and Society for Academic Emergency Medicine
Disclosure: Nothing to disclose.

CME Editor

Gil Z Shlamovitz, MD, Assistant Professor of Emergency Medicine, University of Connecticut School of Medicine; Attending Physician, Emergency Department, Windham Community Memorial Hospital, Willimantic, CT; Attending Physician, Emergency Department, Hartford Hospital, Hartford, CT
Gil Z Shlamovitz, MD is a member of the following medical societies: American Academy of Emergency Medicine and American College of Emergency Physicians
Disclosure: Nothing to disclose.

Chief Editor

Rick Kulkarni, MD, Medical Director, Assistant Professor of Surgery, Section of Emergency Medicine, Yale-New Haven Hospital
Rick Kulkarni, MD is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Emergency Physicians, American Medical Association, American Medical Informatics Association, Phi Beta Kappa, and Society for Academic Emergency Medicine
Disclosure: WebMD Salary Employment

 
 
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