An unusual presentation of foreign body rectum


  • Samir Paruthy East Delhi Medical Centre, Shahdara and Holy Child Nursing Home, Krishna Nagar, Delhi, India
  • Shivani B. Paruthy Department of Surgery, Safdarjung Hospital and VM Medical College, New Delhi, India



Foreign body, Trans anal minimal invasive surgery, Local edema


Retrieval of rectal foreign body (FB) is a surgical dilemma. Variables including FB size, shape, make, time of insertion, presentation in ER, associated injuries, local edema, contamination, reluctance to seek medical aid, multiple unsuccessful attempts for self-retrieval masked by improper history and concealing the actual facts makes surgical management challenging. In this study, two unusual cases of FB in rectum and retrievals were presented. Case 1 was a 22 year old boy with a metallic glass tumbler in rectum reported after 12 days with constipation and pelvic pain. Repeated self-attempts for removal by the patient further pushed the FB upwards. Retrieval of rectal FB was done from rectum with repair and diversion colostomy which was closed later. Patient confessed this was his thirteenth attempt with the same object with successful retrieval all the time in last nine months. Case 2 was a 27 year old boy who inserted a sharp iron rod (used for picking ice) in the anal region which migrated to sigmoid colon without perforation of the viscera. Patient reported after three days with sharp shooting pain in left lower abdomen which aggravated on defecation. Abdominal examination revealed no sign of peritonitis, X-ray and CECT abdomen unexpectedly revealed no viscera perforation. Retrieval of FB stuck at sigmoid colon was undertaken with repair and diversion colostomy and closed later. From the study it was concluded that the retrieval of FB with proper psychological evaluation along with rehabilitation of the patient in society was a multidisciplinary management. Actual algorithm of management of these cases was beyond the surgical clinics and one-time emergency FB retrievals.

Author Biographies

Samir Paruthy, East Delhi Medical Centre, Shahdara and Holy Child Nursing Home, Krishna Nagar, Delhi, India

Consultant Surgeon

Shivani B. Paruthy, Department of Surgery, Safdarjung Hospital and VM Medical College, New Delhi, India

Department of surgery Safdarjung Hospital & Vardhman Mahavir Medical College


Kasotakis G, Roediger L, Mittal S. Rectal foreign bodies: a case report and review of the literature. Int J Surg Case Rep. 2012;3(3):111-5.

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

Unruh BT, Nejad SH, Stern TW, Stern TA. Insertion of foreign bodies (polyembolokoilamania): underpinnings and management strategies. Prim Care Companion CNS Disord. 2012;14(1):01192.

Coskun A, Erkan N, Yakan S, Yildirim M, Cengiz F. Management of rectal foreign bodies. World J Emerg Surg. 2013;8(11).

Lazzari V, Siboni S, Asti E, Bonavina L. Transanal removal of a broken drinking glass self-inserted and retained in the rectum. BMJ Case Rep. 2017.

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

Cawich SO, Thomas DA, Mohammed F, Bobb NJ, Williams D, Naraynsingh V. A management algorithm for retained rectal foreign bodies. Am J Men Health. 2016;11:684-92.

Yaman M, Deitel M, Burul CJ, Shahi B, Hadar B. Foreign bodies in the rectum. Can J Surg. 1993;36(2):173-7.

Smiley O. A glass tumbler in the rectum. JAMA. 1918;72(18):1285.

Khan SA, Davey CA, Khan SA, Trigwell PJ, Chintapatla S. Munchausen's syndrome presenting as rectal foreign body insertion: a case report. Cases J. 2008;1(243).

Waraich NG, Hudson JS, Iftikhar SY. Vibrator-induced fatal rectal perforation. N Z Med J. 2007;120(1260):2685.

Melamed Y, Dalyahu Y, Vaiman R, Bzura G, Bleich A. Foreign objects in the vagina of a mentally ill woman: case series. Gen Hosp Psychiatry. 2007;29(3):270-2.

Forde JC, Casey RG, Grainger R. An unusual penpal: case report and literature review of posterior urethral injuries secondary to foreign body insertion. Can J Urol. 2009;16(4):4757-9.

Zafrullah M. Unusual foreign body in the male urinary bladder and urethra. Br J Clin Pract. 1969;23(3):123-4.

Huffman JC, Stern TA. The diagnosis and treatment of Munchausen's syndrome. Gen Hosp Psychiatry. 2003;25(5):358-63.

Rada RT, James W. Urethral insertion of foreign bodies. A report of contagious self-mutilation in a maximum-security hospital. Arch Gen Psychiatry. 1982;39(4):423-9.

Rahman NU, Elliott SP, McAninch JW. Self-inflicted male urethral foreign body insertion: endoscopic management and complications. BJU Int. 2004;94(7):1051-3.

Nivatvongs S, Metcalf DR, Sawyer MD. A simple technique to remove a large object from the rectum. J Am Coll Surg. 2006;203(1):132-3.

Sharma H, Banka S, Walton R, Memon MA. A novel technique for nonoperative removal of round rectal foreign bodies. Techniq Coloproctol. 2007;11(58):58-9.

Rispoli G, Esposito C, Monachese TD, Armellino M. Removal of a foreign body from the distal colon using a combined laparoscopic and endoanal approach: report of a case. Dis Colon Rectum. 2000;43(11):1632-4.

Goldberg JE, Steele SR. Rectal foreign bodies. Surg Clin North Am. 2010;90(1):173-84.

Aly EH. SILS TEM: The new armamentarium in transanal endoscopic surgery. J Minim Access Surg. 2014;10(2):102-3.

Cawich SO, Mohammed F, Spence R, Albert M, Naraynsingh V. Colonic foreign body retrieval using a modified TAMIS technique with standard instruments and trocars. Case Rep Emerg Med. 2015.

Yahya A, Chukwuma J. Retrospective audit of the management of anal insertion of foreign bodies: a holistic approach. Prim Care Companion CNS Disord. 2016;18(1):10.






Case Series