Approach to the diagnosis and management of retained rectal foreign bodies: clinical update

Retained rectal foreign body is not an uncommon condition, but reliable epidemiological data are not available. The diagnosis and management can present a significant challenge due to delayed presentation and the reluctance of the patients to provide details of the incident. The aim of the clinical evaluation is to identify the type, number, size, shape and location of the foreign body. Removal of retained rectal foreign bodies requires experience, with particular attention to different methods of extracting various objects. Most retained rectal foreign bodies can be successfully extracted transanally under appropriate anaesthesia and only a small proportion, mostly cases of perforation, overt peritonitis, pelvic sepsis or for failure of transanal extraction, will require open surgery or laparoscopy. It is mandatory to perform a proctosigmoidoscopy after anorectal foreign body removal to exclude bowel injury and ensure that the patient has not inserted more than one foreign body. Patients with mucosal abrasion, tears and oedema are to be admitted for a period of observation.