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6.12 Rectal Foreign Body


Presentation

An object is generally inserted by the patient or a partner for sexual stimulation; then it causes pain or bleeding or becomes irretrievable. There may be rectal or lower abdominal pain, obstipation or acute urinary retention. Sometimes the patient will not volunteer that any object has been inserted, or give outlandish explanations such as having sat or fallen onto the object. When interviewed privately, however, the patient will usually give an accurate accounting of the foreign body.

What to do:

What not to do:

Discussion

Most rectal foreign bodies (vibrators, dildos, broom handles, bottles, lightbulbs, balls, fruits, and vegetables) can be removed safely in the emergency department. Some practitioners quite reasonably forego x rays prior to manipulation if the patient is free of pain and fever. The famous gerbil is urban folklore. Consider recommending sexual or psychological counselling.

References:


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from Buttaravoli & Stair: COMMON SIMPLE EMERGENCIES
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Craig Feied, MD
Mark Smith, MD
Jon Handler, MD
Michael Gillam, MD