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FOREIGN BODY OF THE RECTUM

Dr. Robert Ferguson
, presents a case of removal of foreign body from the rectum. This is a 47 year old male admitted to the emergency room with a chief complaint of abdominal pain that started 16 Hs. prior to admission. Physical examined revealed a distended abdomen. Rectal exam showed no masses but traces of blood. An x-ray film of the abdomen is depicted below.

Foreign body of the rectum - (Download Player)
 

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gastric bypass port position

This X-ray film of the abdomen shows a electronic device (with no batteries) located at the recto-sigmoid level. This position was to high for the examiner's finger to palpate it. At the emergency room the patient underwent an attempted removal of the device using a rectoscope, however the object, although visualized, was unable to be retrieved and the patient was transferred to the endoscopy department.

Gastric Bypass enterotomy

After sedation with Meperidine a colonoscope was introduced via the anus. This picture shows the foreign body lodged at the recto-sigmoid level.

gastric bypass division of the mesentery

An attempt was made to grasp the device with a wire snare. This was not possible due to the blunt contour of the object.


gastric bypass entero enterotomy

Biopsy forceps were used to retrieve the device, but again this maneuver failed and pushed the object even further into the colon.

gastric bypass entero enterostomy closure

A gynecological forceps (tenaculum clamp) is introduced into the anus and rectum, and under DIRECT vision the object is grasped and pulled down into the anal canal.

gastric bypass entero enterostomy closure

The object is retreived intact, sparing this patient an operation.


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