How Do You Go About Taking Baby Bottle Cap That Got Stuck in Your Rectum Out

Saudi J Gastroenterol. 2009 Apr; 15(2): 131–132.

Example of Unusual Strange Trunk in the Rectum

Murtaza A. Akhtar

Department of Surgery, NKP Salve Institute of Medical Sciences and Research, Digdoh Hills, Hingna Route, Nagpur - 440 026, Maharashtra, India

Pooja M. Arora

Section of Surgery, NKP Salve Institute of Medical Sciences and Research, Digdoh Hills, Hingna Route, Nagpur - 440 026, Maharashtra, India

Received 2007 Jun 10; Accepted 2007 Nov 18.

Abstract

A 44-year-one-time male patient with a foreign body in rectum (potable bottle), introduced as sexual perversion, is presented with literature review. The management emphasis is on transanal retrieval and ruling out of the rectal and colonic perforation and the requirement for postremoval psychiatric treatment.

Keywords: Foreign torso, rectal trauma, sexual perversions

Foreign trunk within the rectum occurs infrequently. Majority of objects are introduced through anus; however, sometimes a foreign body is swallowed, passes through the gastrointestinal tract and is held upwards in rectum. They are known for potential complications and present as a challenge to clinical management. They should exist seriously and expeditiously treated.

Instance REPORT

A 44-twelvemonth-old male presented with the history of introducing a beverage bottle in the rectum and bleeding per rectum since 1 day. The failure of repeated attempts of self-removal brought the patient to the hospital. He gave history of similar attempts of using objects for sexual gratification in past. Vital signs were normal. Belly was soft. Foreign torso was not palpable per abdomen. X-ray pelvis showed the bottle in lower abdomen and pelvis [Figure one]. Per rectal exam performed later the X-ray of the abdomen, revealed the base of the drinking glass bottle.

10-ray abdomen showing foreign body

The manual removal by holding the base of the canteen was impossible and snares repeatedly slipped due to mucous blanket the surface. Moreover, the bottle could not be manipulated upside downwards in the rectum due to its large size. After exhausting all methods described in the literature, a novel way of begetting the bottle downwardly was attempted and was successful. After reassurance and Iv analgesic, in lithotomy position, patient was encouraged to comport down every bit if he is pushing the faeces. As the bottom of bottle showed upward at anal verge, information technology was grasped by an obstetrics forceps and was removed with gentle traction. Postremoval per rectal examination and sigmoidoscopy did non reveal whatever colorectal injury except some minor anal tears. As patient was a habitual pervert, no major anal tears were noticed. Postremoval recovery was uneventful and patient did not accept anal incontinence or perianal infection. He was referred for psychiatric treatment.

DISCUSSION

Reports of strange torso within the rectum are uncommon in Asia, and the majority of example series are reported from Eastern Europe. [ane–six] Males are usually affected.[1,2] The age group is sixteen-lxxx years;[one] all the same, in that location is a bimodal age distribution, observed in the twenties for anal erotism or forced introduction through anus, and in the sixties mainly for prostatic massage and breaking fecal impactions. The foreign bodies commonly reported were plastic or glass bottles, cucumbers, carrots, wooden, or rubber objects.[2] Other objects reported are bulb, tube lite, axe handle, broomstick, vibrators, etc. The object length varied between six and xv cm, and larger objects were more decumbent for complications.[2]

Abdominal and rectal pains, bleeding per rectum are the common presenting symptoms. Per rectal examination is the cornerstone in the diagnosis, simply it should exist performed afterward 10-ray abdomen to prevent accidental injury to the surgeon from sharp objects. Ten-ray pelvis and 10-ray abdomen help in locating and localizing the strange body and also dominion out intestinal perforation. The lateral films of pelvis volition orient whether the foreign body is high or low lying.

Majority (90%) of the cases is treated by transanal retrieval.[1,2,half dozen,7] Hard objects are potentially traumatic and tend to migrate upwards.[eight] Abdominal manipulation and stabilization helps in retrieval when the bottle is slippery. Obstetric forceps or snares are only helpful in grasping the wide and glace base with limited success. Colonoscopy removal is also reported with expert success.[3] However, express studies in the literature restrict the definition of the major part of colonoscopy. Laparotomy is only required in impacted foreign body and or with perforation peritonitis. Even with laparotomy, the aim is transanal removal and closure of perforation with diversion colostomy. Postretrieval colonoscopy is mandatory to rule out colorectal injury.

In the nowadays case, transanal removal was carried out and the only difficulty was grasping of canteen base with fingers and snares due to mucous and slippery base. Asking the patient to button downwardly the foreign trunk and grasping the base of bottle with obstetric forceps, which gave a firm grip over the base, helped the states to overcome this difficulty. Patient was referred to the psychiatrist for his perversion disorder, which was also mandatory for preventing recurrences.

Footnotes

Source of Support: Zip

Conflict of Interest: None declared.

REFERENCES

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Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2702971/

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