Document Detail


Management of colorectal foreign bodies.
MedLine Citation:
PMID:  8908954     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Colorectal foreign bodies (CFBs) present a serious dilemma regarding extraction and management. In an 11-year period ending March 1994, 48 patients presented to the University of California, San Diego Medical Center and Hammersmith Hospital London with CFBs. Identified patients charts were reviewed in a retrospective manner and the medical literature was reviewed. A wide variety of CFBs were identified and all were extracted transanally. Circumstances surrounding CFB insertion was most commonly sexual stimulation (78%), but included sexual assault (10%). Extraction in the emergency department was successful in 31 (63%) patients. Operating room extraction was performed in 18 (37%) patients; in 12 cases the CFBs were simply extracted under anaesthesia, five patients required primary repair and diverting colostomy for rectal perforation and one required primary repair of an external anal sphincter laceration. Post-extraction observation following simple extraction ranged from immediate discharge to 72 h (mean 13.1 h) and there were no reported complications. A thorough history is essential in order to identify those cases that have resulted from assaults. With adequate sedation, most CFBs can be extracted transanally either in the emergency department or operative suite under direct vision. Sigmoidoscopy is required following extraction to evaluate mucosal injury or perforation. After effortless extraction of a smooth object, with no evidence of mucosal injury, the patient can be discharged after a short period of observation. Rectal perforation can be treated with primary repair and diverting colostomy with low morbidity. This is a relatively common surgical dilemma that requires a thorough history, physical examination, radiographs inventiveness to treat. Additionally, the physician should demonstrate a caring attitude and not subject the patient who is suffering pain and embarrassment to ridicule.
Authors:
J S Cohen; J M Sackier
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the Royal College of Surgeons of Edinburgh     Volume:  41     ISSN:  0035-8835     ISO Abbreviation:  J R Coll Surg Edinb     Publication Date:  1996 Oct 
Date Detail:
Created Date:  1996-12-13     Completed Date:  1996-12-13     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7503110     Medline TA:  J R Coll Surg Edinb     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  312-5     Citation Subset:  IM    
Affiliation:
Department of Surgery, University of California, San Diego, La Jolla, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Colon*
Female
Foreign Bodies / epidemiology,  etiology,  therapy*
Humans
Male
Rectum* / injuries
Retrospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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