Rectal Injury Caused by a Water-Filled Condom: A Case Report

Regarding rectal foreign bodies with gastrointestinal perforation, most objects are hard, and perforation by a condom has not been reported. We describe the case of a 48-year-old man who inserted a water-filled condom into his rectum and performed abdominal crunch exercises for the purpose of sexual arousal. After several repetitions, the condom ruptured. Physical examination revealed signs of peritoneal irritation, and computed tomography confirmed the presence of free air and perirectal fluid accumulation. The patient was diagnosed with acute generalized peritonitis, and emergent laparotomy revealed a full-thickness rectal injury of approximately 10 cm. Simple closure of the damaged bowel was performed, and a proximal diverting colostomy was created. Postoperatively, the patient developed a surgical site infection and was discharged on hospital day 49 following an extended recovery period. The colostomy was subsequently closed without complications. This case highlights that even a condom filled with water can cause upper rectal injury under increased abdominal pressure, such as abdominal exercises.