Rectal Foreign Bodies 
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Collated by Drs. David B. Busch and James R. Starling, Madison, Wis.
The surgical management of two patients presenting with incarcerated, apparently self-inserted foreign bodies is reported. The large volume of prior literature on this subject is reviewed, with tabulation of 182 previous cases by type and number of objects recovered and with a discussion of patients' age distribution, history, complications and prognosis.
Table I Previously reported recovered foreign bodies:
Object Number Recovered Glass or ceramic Bottle or jar 31 Bottle with attached rope 1 Glass or cup 12 Light bulb 7 Tube 6 Food Apple 1 Banana 2 Carrot 4 Cucumber 3 Onion 2 Parsnip 1 Plantain (with condom) 1 Potato 1 Salami 1 Turnip 1 Zucchini 2 Wooden Ax handle 1 Stick or broom handle 10 Miscellaneous or unspecified 3 Sexual Device Vibrator 23* Dildo 15 Kitchen device Dull knife 1 Ice pick 1 Knife sharpener 1 Mortar pestle 2 Spatula (plastic) 1 Spoon 1 Tin cup 1 Miscellaneous tools Candle 1 Flashlight 2 Iron rod 1 Pen 2 Rubber tube 1 Screwdriver 1 Toothbrush 1 Wire spring 1 Inflated device Balloon 1 Balloon attached to cylinder 1 Condom 1 Ball Baseball 2 Tennis ball 1 Miscellaneous containers Baby powder can 1 Candle box 1 Snuff box 1 Miscellaneous Bottle cap ** 1 Cattle horn 3 Frozen pig's tail 1 "Kangaroo tumor" # 1 Plastic rod 1 Stone 2 Toothbrush holder 1 Toothbrush package 1 Whip handle 2* Collections (one case of each) 2 Glass tubes 72 1/2 Jeweler's saw Oil can with potato stopper Piece of wood, peanut Umbrella handle and enema tubing 2 Glasses Phosphorus match ends (homicide) 402 Stones Toolbox ## 2 Bars soap Beer glass and preserving pot Lemon and cold cream jar 2 Apples Spectacles, suitcase key, tobacco pouch, and magazine total of 14 collections, with approximately 500 objects
number may be larger (text unclear) cannot exclude ingestion unique case of pedunculated perianal skin tumor habitually inserted into rectum inside a convict; contained saws and other items usable in escape attempts.
CASE REPORTS
Case 1. A 39-year-old married white male lawyer presented with a self- inserted perfume bottle in his rectum that he was unable to remove using various objects, including a back scratcher. He had inserted this bottle on previous occasions. Edema of the rectum and sigmoid colon precluded the successful manual removal of the object in the emergency room. A pelvic x-ray film (Fig.1) showed the object to be lodged 12 cm proximal to the dentate line. The 3 by 17 cm object, "Impulse Body Spray," was removed manually after a spinal anesthetic. The patient was discharged on the second postoperative day. He refused psychologic counseling.
Case 2. A 39-year-old white male was admitted to the University Hospital psychiatric service for evaluation of a 2-week history of bloody diarrhea and auditory hallucinations. Rectal examination revealed a foreign body approximately 3 cm above the anal verge. An x- ray film (Fig. 2) showed that it was 20 cm in length. The object could not be removed by manual or endoscopic means. The patient consented to extraction of the dildo under general anesthetic. Biopsy specimens of the hemorrhagic rectal mucosa were performed and were negative on Ziehl-Neelson stains for mycobacterial or cryptosporidium infection. The patient was discharged without complications the following day.
Rectal Foreign Bodies, additional casestudies.
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