Probing the Matter: A Case of Rectal Foreign Body Insertion in a Patient With Intellectual Disability

Area of Science:

• Gastroenterology
• Colorectal Surgery
• Psychiatry

Background:

• Rectal foreign body (FB) insertion is an increasing clinical challenge, particularly in males.
• Management requires careful consideration, especially when associated with psychiatric illness or intellectual disability.

Observation:

• A 23-year-old male with mild intellectual disability presented with a retained handheld bidet shower inserted for sexual gratification, a repeat occurrence.
• The object was partially visible externally, potentially misleading inexperienced physicians regarding removal ease.

Findings:

• Radiographic assessment (X-ray) confirmed object position and ruled out complications.
• Successful transanal extraction was performed under general anesthesia without immediate complications.
• Postoperative CT with rectal contrast confirmed no perforation or residual damage.

Implications:

• Highlights the necessity of systematic diagnostic and management protocols for rectal FB extraction, irrespective of apparent retrieval simplicity.
• Emphasizes the critical need for comprehensive psychiatric evaluation and follow-up care in patients with intellectual disability and FB insertion.
• Addresses the social stigma surrounding rectal FB insertion and mental health issues.