Presenter Status
Fellow
Abstract Type
Case report
Primary Mentor
Jose Cocjin
Start Date
8-5-2023 11:30 AM
End Date
8-5-2023 1:30 PM
Presentation Type
Poster Presentation
Description
Introduction: Large rectal foreign bodies are usually difficult to extract, usually requiring operative management.
Case: A 14-year-old male presented to the ER for a rectal foreign body. Earlier in the day, he had rectal itching and inflammation. He used a cylindrical reusable ice stick (for water bottles) for topical relief, which did not work, so he placed the tube in his rectum, then he was unable to retrieve it and sought medical help. Physical exam was significant for lower abdominal pain and palpable mass just below his umbilicus, which was painful to palpate. CT abdomen/pelvis showed a large foreign body in the rectosigmoid colon, measuring 17cm long x 3 cm x 3cm. Surgery was consulted and manual retrieval in the ED was attempted, but unsuccessful. The surgical team recommended an exam under anesthesia (EUA) in the OR with possible diagnostic laparoscopy. Surgery consulted pediatric GI for their assistance with a flexible sigmoidoscopy during the EUA. Flexible EG2900 series colonoscope was introduced through the anus and advanced carefully. The blue cylindrical foreign body was visualized in the sigmoid colon, with mild superficial erosions noted in the adjacent mucosa. The colonoscope was advanced past the tip of the foreign body to visualize the proximal mucosa. Once confident that the foreign body had not eroded through the colonic mucosa, external downward abdominal pressure was applied. Colonoscope was used to help the distal end of the foreign body pass the turns in the colon. This was continued until the colonoscope was at the anal opening. Digital manual retrieval of the rectal foreign body was then successful. The colonoscope was then re-introduced to assess the mucosal damage before the procedure was completed.
Discussion: Using this minimally invasive technique, we were able to avoid a more invasive diagnostic laparoscopy.
Included in
Higher Education and Teaching Commons, Medical Education Commons, Pediatrics Commons, Science and Mathematics Education Commons
Unique Endoscopic Retrieval of a Large Rectal Foreign Body
Introduction: Large rectal foreign bodies are usually difficult to extract, usually requiring operative management.
Case: A 14-year-old male presented to the ER for a rectal foreign body. Earlier in the day, he had rectal itching and inflammation. He used a cylindrical reusable ice stick (for water bottles) for topical relief, which did not work, so he placed the tube in his rectum, then he was unable to retrieve it and sought medical help. Physical exam was significant for lower abdominal pain and palpable mass just below his umbilicus, which was painful to palpate. CT abdomen/pelvis showed a large foreign body in the rectosigmoid colon, measuring 17cm long x 3 cm x 3cm. Surgery was consulted and manual retrieval in the ED was attempted, but unsuccessful. The surgical team recommended an exam under anesthesia (EUA) in the OR with possible diagnostic laparoscopy. Surgery consulted pediatric GI for their assistance with a flexible sigmoidoscopy during the EUA. Flexible EG2900 series colonoscope was introduced through the anus and advanced carefully. The blue cylindrical foreign body was visualized in the sigmoid colon, with mild superficial erosions noted in the adjacent mucosa. The colonoscope was advanced past the tip of the foreign body to visualize the proximal mucosa. Once confident that the foreign body had not eroded through the colonic mucosa, external downward abdominal pressure was applied. Colonoscope was used to help the distal end of the foreign body pass the turns in the colon. This was continued until the colonoscope was at the anal opening. Digital manual retrieval of the rectal foreign body was then successful. The colonoscope was then re-introduced to assess the mucosal damage before the procedure was completed.
Discussion: Using this minimally invasive technique, we were able to avoid a more invasive diagnostic laparoscopy.
