Öz
Rektal yabancı cisim (RFB) acil serviste nadiren karşılaşılan bir klinik tablodur ancak çoğunluğunu erkekler oluşturmaktadır. Bu nesnelerin ağızdan ve anal yoldan alınmasının en yaygın nedeninin istemli cinsel uyarılma olduğu bilinmektedir. Bu hastalar genellikle 20-40 yaş arası cinsel açıdan aktif hastalardır. Bu çalışmada sadece anal bölgeye yerleştirilen rektal yabancı cisimleri değerlendirmeyi ve kendi deneyimimiz ve literatürümüzle bu hastalara bir yönetim stratejisi sunmayı amaçladık. Çalışmamıza 2002-2024 yılları arasında acil servise başvuran ve sadece anal bölgeye yerleştirilen toplam 15 RFB vakası dahil edildi. Çıkarılan nesneler; 6 kozmetik obje, 4 soda şişesi, 3 sebze ve 2 bardak. Hastalarımızın yaklaşık ¾’ünün nedeni cinsel uyarılmaydı. RFB'nin 9'u (%60) anal, 5'i (%33,3) laparotomi ve bağırsak sağımı ile anüse yaklaştırılarak anal çıkarıldı. 1 (%0,66) hastada laparotomi ve kolotomi primer onarımı yapılarak cisim çıkarıldı. RFB tutulması alışılmadık bir klinik tablo olmasına rağmen kolorektal cerrahlar farklı ekstraksiyon yöntemlerine aşina olmalıdır. Hastaların psikolojik travma yaşadığı da akılda tutulmalı ve hastalara yargılayıcı olmayan bir yaklaşımla yaklaşılmalıdır.
Anahtar Kelimeler
Kaynakça
- 1. Hogan VL and Edwards AR. Chief Editor: Vikram Kate. 26 September 2024. Rectal Foreign Body Removal. https://emedicine.medscape.com/article/80963-overview?_gl=1*1nokhme*_gcl_au*Nzg0MTg4MzM1LjE3MjczMzYzMDQ.
- 2. Rocklin MS, Apelgren KN. Colonoscopic extraction of foreign bodies from above the rectum. Am. Surg., 1989;55 :119-23.
- 3. Ruiz Del Castillo J, et al. Colorectal trauma caused by foreign bodies introduced during sexual activity: diagnosis and management. Rev. ESS. Enferm. Dig.2001,;93 : 631-4.
- 4. Cohen J.S., Sackier J.M. Management of colorectal foreign bodies. J. R.Coll. Surg. Edinb.1996; 41: 312-5.
- 5. Zhang X, et al. Case report and literature review: Orally ingested toothpick perforating the lower rectum. Front Surg. 2024; 11:1368762.
- 6. Traub SJ, Hoffman RS, Nelson LS. Body packing--the internal concealment of illicit drugs. N Engl J Med. 2003;349(26):2519-26.
- 7. Ayantunde AA. Approach to the diagnosis and management of retained rectal foreign bodies: clinical update. Tech Coloproctol. 2013;17:13-20.
- 8. Goldberg JE, Steele SR. Rectal foreign bodies. Surg Clin North Am. 2010; Feb.90(1):173-84.
- 9. Stack LB, Munter DW. Foreign bodies in the gastrointestinal tract. Emerg Med Clin North Am. 1996; Aug. 14(3):493-521.
- 10. Huang WC, et al. Retained rectal foreign bodies. J Chin Med Assoc. 2003;66:607–12.
- 11. Kurer MA, et al. Colorectal foreign bodies: a systematic review. Colorectal Dis. 2010;12:851–61.
- 12. Lake JP, et al. Management of retained colorectal foreign bodies: predictors of operative intervention. Dis Colon Rectum 2004;47:1694–8.
- 13. Clarke DL, et al. Colorectal foreign bodies. Colorectal Dis. 2005;7:98–103.
- 14. Subramanian S, Green JS. The general approach and management of the patient who discloses a sexual assault. Mo Med. 2015; 112:211-7.
- 15. Coskun A, et al. Management of rectal foreign bodies . World J Emerg Surg. 2013;8:(1):11.
- 16. Manatakis D, et al. Rectal seed bezoar due to sunflower seed: a case report and review of the literatüre. Pan Afr Med J. 2018 Oct 31;31:157.
- 17. Smith MT, Wong RK. Foreign bodies. Gastrointest Endosc Clin N Am. 2007 Apr;17(2):361-82, vii.
- 18. Choi PW, et al. Rectal foreign body (glass cup) extracted by laparotomy. J Korean Surg Soc. 2008;74:448–51.
- 19. Traub SJ, Hoffman RS, Nelson LS: Body packing - the internal concealment of illicit drugs. N Engl J Med. 2003; 349:2519-26. 10.1056/NEJMra022719
- 20. Elias B, et al. Single incision laparoscopic surgery technique for transanal removal of rectal foreign body. J. Surg. Case Rep. 2014 Mar 20;2014(3):rju022.
- 21. Berci G, et al. An operative proctoscope for foreign-body extraction. Dis. Colon Rectum. 1983;26:193-4.
- 22. Lim K.J, et al. Removal of Rectal Foreign Bodies Using Tenaculum Forceps Under Endoscopic Assistance. Intest. Res. 2015; 13 : 355-9.
- 23. Cologne KG, Ault GT. Rectal foreign bodies: what is the current standard? Clin Colon Rectal Surg. 2012;25:214–8.
- 24. Ooi BS, et al. Management of anorectal foreign bodies: a cause of obscure anal pain. Aust.N. Z. J. Surg.1998;68 : 852-5.
- 25. Barone JE, Sohn N, et al. Perforations and foreign bodies of the rectum: report of 28 cases. Ann. Surg. 1976; 184 : 601-4.
Öz
Rectal foreign body (RFB) is a clinical picture rarely encountered in the emergency department, but the majority of them are men. It is known that the most common reason for these objects taken orally and anally is for voluntary sexual stimulation. These patients are usually sexually active patients between the ages of 20-40. In this study, we aimed to evaluate only rectal foreign bodies placed in the anal region and to present a management strategy for these patients with our own experience and literature. A total of fifteen RFB cases that applied to the emergency department between 2002-2024 and were placed only in the anal region were included in our study. The objects removed were; 6 cosmetic objects, 4 soda bottles, 3 vegetables, and 2 glasses. The reason for approximately ¾ of our patients was sexual stimulation. 9 (60%) of RFB were removed anal, 5 (33.3%) were removed anal with laparotomy and bowel milking by bringing the object closer to the anus. In 1 (0.66%) patient, the object was removed by performing laparotomy and colotomy primary repair. Although RFB retention is an unusual clinical presentation, colorectal surgeons should be familiar with different extraction methods. It should also be kept in mind that patients experience psychological trauma and a nonjudgmental approach should be followed with patients.
Anahtar Kelimeler
Rectum foreign body exraction colonic perforation Management
Kaynakça
- 1. Hogan VL and Edwards AR. Chief Editor: Vikram Kate. 26 September 2024. Rectal Foreign Body Removal. https://emedicine.medscape.com/article/80963-overview?_gl=1*1nokhme*_gcl_au*Nzg0MTg4MzM1LjE3MjczMzYzMDQ.
- 2. Rocklin MS, Apelgren KN. Colonoscopic extraction of foreign bodies from above the rectum. Am. Surg., 1989;55 :119-23.
- 3. Ruiz Del Castillo J, et al. Colorectal trauma caused by foreign bodies introduced during sexual activity: diagnosis and management. Rev. ESS. Enferm. Dig.2001,;93 : 631-4.
- 4. Cohen J.S., Sackier J.M. Management of colorectal foreign bodies. J. R.Coll. Surg. Edinb.1996; 41: 312-5.
- 5. Zhang X, et al. Case report and literature review: Orally ingested toothpick perforating the lower rectum. Front Surg. 2024; 11:1368762.
- 6. Traub SJ, Hoffman RS, Nelson LS. Body packing--the internal concealment of illicit drugs. N Engl J Med. 2003;349(26):2519-26.
- 7. Ayantunde AA. Approach to the diagnosis and management of retained rectal foreign bodies: clinical update. Tech Coloproctol. 2013;17:13-20.
- 8. Goldberg JE, Steele SR. Rectal foreign bodies. Surg Clin North Am. 2010; Feb.90(1):173-84.
- 9. Stack LB, Munter DW. Foreign bodies in the gastrointestinal tract. Emerg Med Clin North Am. 1996; Aug. 14(3):493-521.
- 10. Huang WC, et al. Retained rectal foreign bodies. J Chin Med Assoc. 2003;66:607–12.
- 11. Kurer MA, et al. Colorectal foreign bodies: a systematic review. Colorectal Dis. 2010;12:851–61.
- 12. Lake JP, et al. Management of retained colorectal foreign bodies: predictors of operative intervention. Dis Colon Rectum 2004;47:1694–8.
- 13. Clarke DL, et al. Colorectal foreign bodies. Colorectal Dis. 2005;7:98–103.
- 14. Subramanian S, Green JS. The general approach and management of the patient who discloses a sexual assault. Mo Med. 2015; 112:211-7.
- 15. Coskun A, et al. Management of rectal foreign bodies . World J Emerg Surg. 2013;8:(1):11.
- 16. Manatakis D, et al. Rectal seed bezoar due to sunflower seed: a case report and review of the literatüre. Pan Afr Med J. 2018 Oct 31;31:157.
- 17. Smith MT, Wong RK. Foreign bodies. Gastrointest Endosc Clin N Am. 2007 Apr;17(2):361-82, vii.
- 18. Choi PW, et al. Rectal foreign body (glass cup) extracted by laparotomy. J Korean Surg Soc. 2008;74:448–51.
- 19. Traub SJ, Hoffman RS, Nelson LS: Body packing - the internal concealment of illicit drugs. N Engl J Med. 2003; 349:2519-26. 10.1056/NEJMra022719
- 20. Elias B, et al. Single incision laparoscopic surgery technique for transanal removal of rectal foreign body. J. Surg. Case Rep. 2014 Mar 20;2014(3):rju022.
- 21. Berci G, et al. An operative proctoscope for foreign-body extraction. Dis. Colon Rectum. 1983;26:193-4.
- 22. Lim K.J, et al. Removal of Rectal Foreign Bodies Using Tenaculum Forceps Under Endoscopic Assistance. Intest. Res. 2015; 13 : 355-9.
- 23. Cologne KG, Ault GT. Rectal foreign bodies: what is the current standard? Clin Colon Rectal Surg. 2012;25:214–8.
- 24. Ooi BS, et al. Management of anorectal foreign bodies: a cause of obscure anal pain. Aust.N. Z. J. Surg.1998;68 : 852-5.
- 25. Barone JE, Sohn N, et al. Perforations and foreign bodies of the rectum: report of 28 cases. Ann. Surg. 1976; 184 : 601-4.
Ayrıntılar
| Birincil Dil | İngilizce |
|---|---|
| Konular | Uygulama Bilimi ve Değerlendirme |
| Bölüm | Araştırma Makalesi |
| Yazarlar | |
| Gönderilme Tarihi | 7 Ocak 2025 |
| Kabul Tarihi | 19 Haziran 2025 |
| Yayımlanma Tarihi | 21 Haziran 2025 |
| IZ | https://izlik.org/JA45LW48ZJ |
| Yayımlandığı Sayı | Yıl 2025 Cilt: 47 Sayı: 2 |