Rectal foreign body causing perforation: Case report and literature review

Area of Science:

• Gastroenterology
• Surgical Pathology
• Psychiatric Comorbidities

Background:

• Anorectal foreign bodies (FB) present diagnostic challenges due to patient embarrassment or psychiatric factors.
• A high index of suspicion is crucial for timely diagnosis and management.
• Evidence-based surgical algorithms for anorectal FB are lacking.

Observation:

• A 46-year-old male with schizophrenia and bipolar disorder presented with septic shock and severe abdominal pain.
• CT revealed rectal perforation with a screwdriver FB, leading to exploratory laparotomy.
• Surgical management included rectal resection, abscess drainage, and colostomy.

Findings:

• Rectosigmoid perforation by a screwdriver FB.
• Successful surgical management involving resection and colostomy.
• Patient recovery and discharge to behavioral health services.

Implications:

• Emphasizes the importance of considering FB in patients with unexplained abdominal pain, particularly those with psychiatric conditions.
• Underscores the need for further research to establish standardized surgical approaches for anorectal perforations.
• Highlights the multidisciplinary approach required for managing complex cases involving foreign bodies and psychiatric comorbidities.