Rectal foreign bodies

　　What causes rectal foreign bodies?

　　1. Accidental ingestion or accidental vomiting of foreign objects that can be impacted.

　　2. Gallstones or fecal stones and other impacted objects in the rectum.

　　3. Iatrogenic foreign bodies left in the intestines.

　　In addition to its clinical manifestations, rectal foreign bodies can also cause other diseases. This condition can cause abdominal and rectal perforation, peritonitis, and toxic shock, which should attract the high attention of both clinical doctors and patients.

　　Sudden severe pain during defecation should be suspected of a penetrating foreign object, which is just stopped at the anal-rectal junction or above. Other symptoms depend on the size and shape of the foreign object, the duration of its stay in the original position, and whether there is infection or perforation.

　　Foreign objects usually stop in the middle segment of the rectum, where they cannot pass through the anterior flexion angle of the rectum. When performing rectal examination, the object can be felt, and it may be necessary to perform abdominal and chest X-ray examinations to rule out perforation in the abdominal and rectal cavities.

　　Sudden severe pain during defecation should suspect a penetrating foreign body. Rectal foreign bodies severely affect the daily life of patients, so they should be actively prevented. Prevention should pay attention to avoiding accidental ingestion and actively treating internal organ stones.

　　Foreign bodies usually stop at the middle segment of the rectum, where they cannot pass through the anterior flexion angle of the rectum. The foreign body can be felt during rectal examination. It may be necessary to perform abdominal and chest X-ray examinations to rule out perforation in the abdominal cavity and rectum.

　　1. X-ray abdominal film:An abdominal X-ray is a photograph of the abdomen taken without introducing any contrast material. When a certain organ calcifies due to disease, or there is a non-radio-opaque foreign body, calculus, or free gas in the abdominal cavity, or there is an increase in gas and liquid in the intestinal cavity or dilation of the intestines, there will be differences in density displayed on the photograph. Pure metal foreign bodies can be diagnosed positively by X-ray examination.

　　2. Barium meal:Non-metallic foreign bodies can be very helpful through barium swallow imaging. If there is bleeding or perforation, barium meal examination should be prohibited.

    The diet of rectal foreign body patients should be light and easy to digest, with more fruits and vegetables, a reasonable diet, and attention to adequate nutrition. In addition, patients should also pay attention to avoid spicy, greasy, and cold foods.

　　Precautions before treatment of rectal foreign bodies:

　　If a foreign body is touched, 0.5% lidocaine or bupivacaine containing 150u/15ml hyaluronidase can be injected subcutaneously and submucosally for local anesthesia. Then, the anus is dilated with a rectal retractor, the foreign body is grasped, turned, and removed. If the foreign body cannot be touched, the patient usually needs to be hospitalized. Peristalsis often pushes the foreign body to the middle of the rectum, then the above routine operation is performed. However, sigmoidoscopy or rectoscopy for removing foreign bodies is rarely successful, and sigmoidoscopy examination can push the foreign body to the proximal position, thus delaying the removal of the foreign body. In a few cases, local anesthesia or general anesthesia may be required, and occasionally, laparotomy may be needed to push the foreign body towards the anus or to perform a colotomy to remove the foreign body. After the foreign body is removed, sigmoidoscopy should be performed to exclude obvious rectal trauma or perforation.