Principles of management of colorectal foreign bodies

We present a five-year experience with removal of 31 colorectal foreign bodies, with no morbidity or mortality. The following principles were used: (1) biplane abdominal roentgenograms to elucidate the location, type, and number of foreign bodies; (2) removal under appropriate anesthesia; (3) transanal extraction of the foreign bodies whenever possible; (4) laparotomy only as a last resort, after failure of all transanal manipulations; (5) proctosigmoidoscopy following removal of foreign bodies; and (6) inpatient observation to rule out bleeding or perforation with delayed symptoms. A classification based on the level of the foreign bodies in the rectum or colon is proposed that is helpful in the initial approach to the problem and the ultimate therapeutic plan.