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Published on: September 11, 2018
Rectal foreign body and its association with social stigma and mental health: A case report
Anurag Pokharel1, Jitendra Kumar Singh1, Bishow Raj Khadka2
1Gorkha Hospital, Gorkha, Nepal.
Introduction:
Rectal foreign bodies (FB), as a cause of surgical emergency are on the rise. The management is usually uneventful but delays in presentation are associated with complications and morbidity. Psychiatric illnesses account for a vast majority of FB insertion cases which is usually overlooked.
Case Presentation:
56 year male with alleged history of insertion of a discarded bottle of insecticide into his rectum 6 weeks ago. He presented late, in sepsis due to lack of family support and social taboo, in sepsis. The foreign body was extracted by trans-anal approach with no evidence of bowel injury on laparoscopy. Psychiatry consultation revealed alcohol-induced psychosis which was managed.
Clinical Discussion:
Insertion of foreign bodies voluntarily for sexual gratification is common, apart from some accidental cases. There is delay in seeking medical attention, complicated by many social factors. Multiple approaches to management are in practice. Psychiatric component is linked in part to the primary act, delayed presentation and recurrence.
Conclusion:
Foreign body insertion into anatomical orifices is on the rise. Management can be complicated by body of interest, patient and social factors. Psychiatric history, evaluation and corresponding management is a must for all cases. Social awareness can help reduce incidence and the delay in seeking medical care.
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