Objects that have been inserted into the rectum intentionally or swallowed may become stuck.
Symptoms depend on the size and shape of the object and whether there are any complications.
The diagnosis is based on a physical examination, x-rays, and computed tomography.
If the doctor is not able to remove the object with a retractor, it is removed surgically.
The rectum is the section of the digestive tract above the anus where stool is held before it passes out of the body through the anus. The anus is the opening at the end of the digestive tract where stool leaves the body. (See also Overview of the Anus and Rectum Overview of the Anus and Rectum The anus is the opening at the end of the digestive tract where stool leaves the body. The rectum is the section of the digestive tract above the anus where stool is held before it passes out... read more .)
The Digestive System
Swallowed objects, such as toothpicks, chicken bones, or fish bones, may become stuck at the junction between the anus and rectum (called the anorectal junction). Also, enema tips, surgical sponges or instruments, thermometers, and objects used for sexual stimulation may become stuck unintentionally in the rectum after being passed through the anus. Drug packets inserted in an attempt to conceal them from law enforcement officials may be inserted intentionally but become stuck unintentionally.
Symptoms of Rectal Foreign Objects
Sudden, excruciating pain during bowel movements suggests that a foreign object, usually at the anorectal junction, is penetrating the lining of the anus or rectum. Other symptoms depend on the size and shape of the object, how long it has been there, and whether it has perforated (pierced) the anus or rectum or caused an infection.
Diagnosis of Rectal Foreign Objects
A doctor's examination
Sometimes imaging of the abdomen and chest
A doctor may be able to feel the object by probing with a gloved finger during an examination.
X-rays Plain X-Rays X-rays are high-energy radiation waves that can penetrate most substances (to varying degrees). In very low doses, x-rays are used to produce images that help doctors diagnose disease. In high... read more of the abdomen and chest can help doctors identify the object and determine whether complications have occurred. Computed tomography Computed Tomography (CT) In computed tomography (CT), which used to be called computed axial tomography (CAT), an x-ray source and x-ray detector rotate around a person. In modern scanners, the x-ray detector usually... read more (CT) may be done if the object cannot be identified with x-rays.
Treatment of Rectal Foreign Objects
If the object can be felt, removal by rectal retractor
If the object cannot be felt or seen, removal by surgery
After removal, sigmoidoscopy
If a doctor can feel the object, a local anesthetic Local anesthesia and regional anesthesia Surgery is the term traditionally used to describe procedures (called surgical procedures) that involve manually cutting or stitching tissue to treat diseases, injuries, or deformities. However... read more is usually injected under the skin and lining of the anus to numb the area. The anus can then be spread wider with an instrument called a rectal retractor, and the object can be grasped and removed. Sometimes doctors give general anesthesia General anesthesia Surgery is the term traditionally used to describe procedures (called surgical procedures) that involve manually cutting or stitching tissue to treat diseases, injuries, or deformities. However... read more , which relaxes the anus and allows the object to be removed without surgery.
If a doctor cannot feel the object or if the object cannot be seen and removed through the anus, the doctor waits until the natural wave-like movements of the wall of the large intestine (called peristalsis) bring the object down, making removal possible.
If the doctor is unable to remove the foreign body, the person is hospitalized and surgery is needed. During surgery, the person is given a regional or general anesthetic Anesthesia Surgery is the term traditionally used to describe procedures (called surgical procedures) that involve manually cutting or stitching tissue to treat diseases, injuries, or deformities. However... read more and the object is gently moved toward the anus. Rarely, the rectum needs to be cut open to remove the object.
After the object is removed, the doctor does a sigmoidoscopy (a flexible tube is inserted into the anus to view the lower portion of the large intestine, the rectum, and the anus) to determine whether the rectum has been perforated or otherwise injured.