Rectal Impaction of a Migratory Duck Bone After 72 Asymptomatic Hours: A Defused Time Bomb

This case describes a 72-h asymptomatic migration of a 3.3 cm duck bone culminating in rectal impaction that triggered severe anal pain. Despite many sharp objects causing perforation within 24 h, this patient experienced no symptoms until sudden anal pain after 72 h. Computed X-ray tomography scan (CT) confirmed rectal impaction without perforation, and colonoscopy revealed longitudinal impaction 5 cm from the anal verge. Endoscopic extraction was performed, after which a superficial mucosal injury (approximately 0.3 cm × 0.15 cm) at the impaction site was visualized, with immediate pain resolution. The favorable outcome is attributed to persistent longitudinal orientation minimizing penetration forces and distal rectal impaction where thicker musculature and sparse vasculature provided anatomical protection. We emphasize detailed dietary history review for acute anal pain and propose risk-stratified management for asymptomatic ingestion: close radiographic surveillance for low-risk objects, early endoscopic retrieval for high-risk objects, and surgical intervention if endoscopy fails or is not feasible.