SAQ 361 – Surgery – rectal foreign body

Surgery – rectal foreign body.

a. X-ray

• Rectal foreign body.
• No obvious perforation, noting the supine AXR is insensitive and does not show the diaphragms.

b. Complications

• Rectal mucosal abrasion/laceration and bleeding.
• Perforation, including iatrogenic perforation.

c. Operating theatre factors

• Sharp or potentially dangerous object.
• Failed ED extraction.
• Patient unsuitable for ED attempt or anaesthetic risk.
• Object proximal to sigmoid.
• Signs suggestive of perforation.

d. Anaesthesia

• Procedural sedation, for example propofol with fentanyl.
• Regional anaesthesia such as perianal block.

e. Removal techniques

• Valsalva manoeuvre with generous lubricant.
• Gentle traction with generous lubricant.
• Foley catheter with 50 mL balloon and traction.