Foreign bodies in the anus and rectum
Classification according to ICD-10 | |
---|---|
T18.5 | Foreign bodies in the anus and rectum |
ICD-10 online (WHO version 2019) |
A rectal foreign body , often rectal foreign body ( English rectal foreign body ), is a mostly through the anus into the rectum (rectum or Latin rectum introduced) and those under there object. It can become clinically relevant if it cannot be easily removed by the patient in the intended manner. The reverse route of a foreign body - intake via the mouth and passage through the entire gastrointestinal tract into the rectum - is rarely clinically relevant.
Rectal foreign bodies belong to the group of gastrointestinal foreign bodies (foreign bodies in the digestive organs).
frequency
There are no reliable data on the incidence of clinically relevant rectal foreign bodies. It is likely to have increased over the long term and has recently become a phenomenon that has been observed more frequently. The number of unreported cases is probably very high.
Foreign bodies in the anus and rectum are much more common in men than in women. The gender ratio is approximately 28: 1. A 2010 meta-study found a gender ratio of approximately 37: 1. The mean age of the patients was 44.1 years with a standard deviation of 16.6 years.
The first case described in the literature dates back to the 16th century.
causes
The reasons for foreign bodies in the anus and rectum are very different, but in most cases they are sexually or criminally motivated. In the vast majority of cases, the foreign body is voluntarily inserted into the rectum. This primarily includes sexually motivated practices , which are the most common cause of clinically relevant rectal foreign bodies. Bodypacking , the illegal transport of drug containers in body orifices (here: in the rectum), is another - possibly - voluntary form of introducing foreign bodies into the anus and rectum. This also includes attempts to transport objects such as weapons, such as knives, or ammunition. In one study, sexual stimulation was responsible for about 80 percent of the cases where a foreign body in the anus and rectum became clinically relevant. Included in the 80 percent are around ten percent cases of sexual assault .
It is also rare that the patient himself introduces foreign bodies into the anus that can no longer be removed on their own in order to get the affection and pity of doctors and nurses. In these cases the behavior is assigned to Munchausen syndrome .
Another cause can be a supposed self-treatment of diseases. For example, one patient tried to treat stubborn diarrhea by inserting a corn cob into his rectum . Another patient tried to relieve the chronic itching ( pruritus ani ) caused by his hemorrhoid disease with the help of a toothbrush . The toothbrush got out of control and disappeared into his rectum.
Foreign objects can enter the rectum against the patient's will through accidents or torture . A mercury clinical thermometer that was inserted into the rectum to measure temperature and broke off is an example of an accidental foreign body. In ancient Greece, for example, there was a radish punishment for male adulterers , in which a radish was inserted into the anus of the adulterer . Many self-introduced foreign bodies are declared as accidents by the affected patients out of shame .
Foreign objects can easily become lodged in the rectum for several reasons. On the one hand, many of the objects used for sexual stimulation are conically shaped at their tips, so that easier penetration is guaranteed. At the end, however, they are mostly flat. If the end of the object passes the anus in the direction of the rectum, extraction by the person concerned is no longer possible in many cases. Often the object is inserted much deeper into the rectum than originally planned, in order to receive stronger stimulation. The sphincters then mechanically prevent the extraction of the foreign body.
Objects
The type and size of the rectal foreign bodies vary widely and in some cases exceed the anatomical-physiological imagination. ( see also: fisting )
The objects described in the specialist literature include, for example:
- Razor blade , screw , screwdriver , small rolled up tool bag (15 × 12 cm, including tool 620 g), hairpin , can punch
- Bones , shards of bone
- Various types of drug containers ( see also: Bodypacking )
- short sticks like a 27 cm long chair leg , a 19 cm long spade handle and a broken broom handle , vacuum cleaner attachments , tots in a cover
- Vessels with a volume of more than 0.5 l in some cases , such as small champagne bottles , cola bottles , jam glasses , small beer glasses , cups
- Spray can , light bulb , radio tube , candle
- Table tennis ball , bocce ball
- Rifle ammunition , New Year's Eve firecrackers
- Cucumber , carrot , corn on the cob , banana , apple , onion , carved pieces of ginger
- rolled daily newspaper
- frozen pork tail
- eel
- Vibrator , hard rubber stick , dildo , vaginal balls
- Plastic toothbrush case
- intestinal tubes too short
It doesn't always have to be solid objects. In 1987, for example, a case was described of a patient who administered an enema with a cement mixture . After the mixture solidified and wedged, the resulting cement chunk had to be surgically removed. Another extreme example occurred in November 1953. A depressed man inserted a six inch cardboard tube into his rectum and then threw a lit firework into the opening of the tube, tearing a large hole in his rectum.
diagnosis
![](https://upload.wikimedia.org/wikipedia/commons/thumb/f/f8/Rectal_foreign_body_01.jpg/220px-Rectal_foreign_body_01.jpg)
For reasons of shame, many patients are reluctant to provide information about what happened when taking their anamnesis , so that information important for therapy may be missing. In addition, for the same reason, patients appear very late (“when there is no other way”) to see a doctor. A trusting, sensitive and caring care of the mostly very embarrassed and uncomfortable patients by the involved clinical staff is therefore of great importance for the success of the treatment and can possibly be life-saving.
Before removing the foreign body, radiological images are usually recorded in different projection planes in order to determine the exact position and depth of the foreign body. This is usually done by x-rays . In the case of foreign bodies made of materials that provide too little contrast in the X-ray image (e.g. objects made of solid plastic), sonography (ultrasound) or computed tomography can be used if necessary . The magnetic resonance imaging is particularly the case of unknown debris contraindicated . Foreign bodies introduced into the rectum may penetrate far into the colon, in some cases the right flexure .
An endoscopy , which can also be useful in therapy, enables the identification and location of the object in the rectum.
The information about the foreign body obtained in this way is very important for its removal, as perforation of the rectum and anus must be avoided at all costs .
therapy
The therapeutic measures for removing the foreign body can be as varied as the objects in the rectum can be. Often the foreign bodies are made of fragile materials such as glass. In addition, it usually takes many hours or even days before the patient see a doctor. Before consulting a doctor, most patients try unsuccessfully several times to remove the foreign body themselves or through another layperson. In many cases this worsens the starting position for a successful extraction of the foreign body.
In most cases, the foreign body can be removed endoscopically. For example, vibrators can usually be grasped and removed from the rectum with a large polypectomy snare (usually used to remove polyps during colonoscopy ). Smaller objects, such as clinical thermometers , can also be extracted from the rectum using biopsy forceps . Large jammed objects often cannot be moved with a flexible endoscope. In these cases, rigid instruments are often better suited.
In some cases, instruments normally used for obstetrics have proven effective in removing the foreign body. These include the forceps (forceps) and the suction cup . Furthermore, wooden objects with corkscrews and drinking glasses were recovered after pouring plaster of paris. With the glasses, for example, a spoon can be poured into the still liquid plaster as an “anchor” and pulled out together with the glass after it has solidified. Light bulbs are usually covered with a mesh of bandage gauze , smashed in the rectum and then extracted.
The argon plasma coagulation has already been used successfully. The foreign body to be removed was a green apple wrapped in cellophane in the rectum of a 44-year-old patient. Argon plasma coagulation allowed the apple to shrink by over 50 percent of its size and ultimately to be removed. Previous extraction attempts with endoscopic instruments failed because of the smooth surface of the object.
If the foreign body cannot be extracted by any of the above measures because it is too high in the sigmoid colon , bed rest and sedation of the patient can cause the foreign body to descend back into the rectum in many cases. There the foreign body is easier to reach and easier to extract.
In more difficult cases, an abdominal incision (laparotomy) may be necessary. Statistically speaking, this is necessary in around 10 percent of the cases. The large intestine can then possibly be manipulated via the open abdomen in such a way that the foreign body migrates towards the anus and can be grasped there. The opening of the large intestine ( colotomy ) can be indicated in particularly difficult cases, especially if manipulation of the foreign body would seriously endanger the patient's health. This can be the case, for example, with jammed drug condoms.
anesthesia
In the lighter cases, sedation of the patient is usually sufficient . Local and spinal anesthesia are also often used. More difficult procedures are usually performed under anesthesia ; It is absolutely necessary when opening the abdominal cavity (laparotomy) and opening the colon (colotomy). Anesthetics for the relaxation of the sphincter muscles (sphincters) advantageous.
Aftercare
After the operation, a sigmoidoscopy is recommended - a colonoscopy in which 30 to 40 centimeters of the large intestine and rectum are examined with a flexible endoscope - in order to rule out possible perforations of the rectum and the sigmoid colon , or to detect injuries to the mucous membranes. In-patient follow-up is indicated in some cases.
Sample list
foreign body | technology | anesthesia | source |
---|---|---|---|
pen | Polypectomy snare | k. A. | |
balloon filled with water | Puncture | k. A. | |
Chicken bones | Polypectomy snare | k. A. | |
toothpick | Polypectomy snare | k. A. | |
Apple in cellophane | Defragmentation with APC | no | |
glass bottle | Biopsy forceps | general anesthetic | |
vibrator | Polypectomy snare | no | |
Test tube | inflated Sengstaken probe | k. A. | |
Test tube | Polypectomy snare | k. A. | |
Tip of an enema | Polypectomy snare | k. A. | |
vibrator | Biopsy forceps | k. A. | |
pencil | Polypectomy snare | k. A. | |
Iron rod | Two-channel colonoscope and wires | k. A. | |
Bottleneck | inflated Foley catheter | general anesthetic | |
Spray container | Achalasia balloon | no | |
spongy toy ball | Suction cup | general anesthetic | |
vibrator | Obstetric forceps and anal dilation | Local anesthesia | |
vibrator | Hook pliers | Local anesthesia | |
Aftershave bottle | Bone holding forceps with rubber feet | Spinal anesthesia | |
Chicken bones | with fingers | no | |
Spray can lid | pointed grasping forceps and anal dilatation | general anesthetic | |
vase | Filling in with plaster | general anesthetic | |
Glass vessel | Extraction with plaster of paris | Spinal anesthesia | |
Glass vessel | Endotracheal tube | Local anesthesia | |
Apple | two-handed editing | Local anesthesia | |
Glass vessel | inflated Foley catheter | general anesthetic | |
glass bottle | Suction cup | general anesthetic | |
100 watt incandescent lamp | three inflated Foley catheters | k. A. | |
thermometer | Biopsy forceps | general anesthetic | |
vibrator | transanal Kocher clamp | Local anesthesia | |
Bowling bottle (bottle in the shape of a pin) | Obstetric forceps | general anesthetic | |
Perfume bottle | manually | Spinal anesthesia | |
Piece of wood | manually | general anesthetic | |
Toothbrush case | inflated Fogarty catheter | k. A. | |
Oven glove | Forceps after anal dilation | general anesthetic | |
Drainpipe | Obstetric forceps | general anesthetic | |
Boule ball | Electromagnet | general anesthetic | |
carrot | Myoma lifter | k. A. | |
Vitreous | Suction cup | Spinal anesthesia | |
Rubber ball | manual extraction with anal dilation | general anesthetic | |
Wooden stick | two-handed anal dilation | Spinal anesthesia | |
bottle | manually after anal dilation | general anesthetic | |
Dildo | Myoma lifter | k. A. | |
Lightbulb | abdominal compression | Spinal anesthesia |
Data after
- APC = argon plasma coagulation
- k. A. = not specified
Possible consequences of a foreign body not being removed
If the foreign body is so large that no stool from the colon can pass through it, a mechanical intestinal obstruction (ileus) occurs. The stretching of the rectum and the resulting disruption of the intestinal peristalsis also promote ileus.
The foreign body can destroy the intestinal wall through inflammatory processes ( erosion ). This may, depending on the location of the perforation, a muddy peritonitis or retroperitoneal abscess formation (formation of an abscess behind the peritoneum lead).
Smaller foreign bodies that injure the intestinal wall but do not perforate it can become trapped in a foreign body granuloma . They may then remain in the rectum for years as a pseudotumor without any consequences.
Complications
The most common - but generally rare - complication is perforation of the rectum by the foreign body itself or by the measures taken to remove it. Diagnosed perforations are usually operated on immediately in the clinic. To do this, the patient's abdomen is opened (laparotomy) and the perforated area is either cut out or treated with a primary suture . Patients are usually antibiotics administered to infections to suppress. In order to protect the sutures, a temporary relieving colostomy, i.e. a temporary artificial anus, is usually necessary. The relieving colostomy is shifted back after a contrast agent injected as an enema has demonstrated that the previously perforated area of the rectum has completely healed. This typically takes three to six months from the time of the operation. According to a study, the average hospital stay after a perforation is 19 days.
Some deaths from foreign bodies in the anus and rectum have been described in the literature, but are generally very rare. Deaths are assigned to the group of autoerotic suicide accidents . For example, a 75-year-old patient died from a perforation in his rectum made by a mentally ill patient with a walking stick. Another middle-aged patient died of a perforation in his rectum by a vibrator. The perforation was sutured and the patient was given intensive care, but as a result of the trauma he developed Acute Respiratory Distress Syndrome (ARDS) and Systemic Inflammatory Response Syndrome (SIRS), which ultimately led to multiple organ failure . A death is also described after perforation of the rectum by a shoehorn . After a surgical procedure, the rectum should be spared until it is completely healed. A 54-year-old, the previously twice a rectal foreign body be removed surgically had (cucumber and parsnips ), died of peritonitis (peritonitis) since moving to the previous operation - introduced two apples into his rectum - and before complete healing of the wound .
Rectal foreign bodies by ingestion
The reverse route of a foreign body - oral ingestion and passage through the entire gastrointestinal tract into the rectum - is very often followed, but is rarely clinically relevant. Other constrictions such as the esophagus , stomach mouth , pylorus and ileocecal valve usually lead to problems in other organs if foreign bodies are large enough. However, some foreign bodies pass the bottlenecks on the way to the rectum and can lead to clinically relevant problems in the rectum. These include toothpicks and bones, for example. Especially with bones, for example of chickens, there is a risk of perforation of the intestine. Almost half of all perforations are caused by bones.
Plant-based foods, especially seeds such as popcorn or watermelon , sunflower and pumpkin seeds , can also aggregate in the colon to form bezoars that are too large for normal anal passage and can thus become clinically relevant as rectal foreign bodies. This type of rectal foreign body occurs primarily in children and is of particular clinical importance in North Africa and the Middle East , where such kernels are an important part of the diet. In rare cases, plant seeds from such bezoars can germinate in the colon and / or rectum and also lead to blockages in this way.
Rectal foreign bodies in veterinary medicine
Rectal foreign bodies are rare in veterinary medicine . A foreign body passage through the entire intestine and then remaining in the rectum is - analogous to the situation in humans - a rather rare occurrence. Bezoars made of various materials can also be found in animals , and they can get into the rectum and cause problems there. Atypical rectal foreign bodies in animals of both sexes can also occur as a result of sexually and / or sadistically motivated abuse.
Ig Nobel Prize
The Ig Nobel Prize was awarded to David B. Busch and James R. Starling from Madison (Wisconsin) in 1995 for their article Rectal foreign bodies: Case Reports and a Comprehensive Review of the World's Literature (German: "Rectal foreign bodies: case studies and a comprehensive overview of the worldwide literature ”) (see list of winners of the Ig Nobel Prize ).
further reading
Reference books
- E. Stein: Proctology: Textbook and Atlas. Verlag Springer, 2002, ISBN 3-540-43033-4 , p. 329f. limited preview in Google Book search
Review article
- G. Kasotakis, L. Roediger, S. Mittal: Rectal foreign bodies: A case report and review of the literature. In: International journal of surgery case reports. Volume 3, Number 3, 2012, pp. 111-115, ISSN 2210-2612 . doi: 10.1016 / j.ijscr.2011.11.007 . PMID 22288061 . PMC 3267241 (free full text).
- JE Goldberg, SR Steele: Rectal foreign bodies. In: Surgical Clinics of North America . 90, 2010, pp. 173-184. doi: 10.1016 / j.suc.2009.10.004 PMID 20109641
- M. Paynter: Practice makes perfect. Rectal foreign bodies. In: Emerg Nurse. 15, 2008, pp. 22-24. PMID 18372783
Original research
- R. Flores-Suarez, J. Reyes-del Valle: Images in clinical medicine. A foreign body. In: The New England Journal of Medicine , Volume 363, Number 18, Oct. 2010, pp. 1748, ISSN 1533-4406 . doi: 10.1056 / NEJMicm0707656 . PMID 20979475 .
- EJ van der Wouden, BD Westerveld: Extraction of a rectal foreign body using a custom-made giant snare. In: Endoscopy , Volume 42 Suppl 2, 2010, pp. E122, ISSN 1438-8812 . doi: 10.1055 / s-0029-1244009 . PMID 20306405 .
- D. Song, CS Chen et al. a .: Nonoperative management for large rectal foreign body removal. In: Colorectal Disease , Volume 13, Number 6, June 2011, pp. E163-e164, ISSN 1463-1318 . doi: 10.1111 / j.1463-1318.2010.02408.x . PMID 20846300 .
- P. Billi, M. Bassi, F. Ferrara, A. Biscardi, S. Villani, F. Baldoni, N. D'Imperio: Endoscopic removal of a large rectal foreign body using a large balloon dilator: report of a case and description of the technique. In: Endoscopy , Volume 42 Suppl 2, 2010, p. E238, ISSN 1438-8812 . doi: 10.1055 / s-0030-1255573 . PMID 20931459 .
- R. Durai, D. Biradhar, PC Ng: Two port laparoscopic-assisted removal of a migrating rectal foreign body. In: Techniques in Coloproctology , Volume 14, Number 3, September 2010, pp. 263-264, ISSN 1128-045X . doi: 10.1007 / s10151-009-0548-5 . PMID 19997954 .
- S. Arora, H. Ashrafian, ED Smock, P. Ng: Total laparoscopic repair of sigmoid foreign body perforation. In: Journal of laparoendoscopic & advanced surgical techniques. Part A , Volume 19, Number 3, June 2009, pp. 401-403, ISSN 1092-6429 . doi: 10.1089 / lap.2008.0242 . PMID 19245310 .
- CG Ball, AD Wyrzykowski, P. Sullivan, DV Feliciano: Intussuscepted intestine through a rectal foreign body. (PDF; 186 kB) In: Canadian journal of surgery. Journal canadien de chirurgie , Volume 52, Number 5, October 2009, pp. E191-E192, ISSN 1488-2310 . PMID 19865554 . PMC 2769092 (free full text).
- SI Andrabi et al. a .: Extraction of a rectal foreign body - an alternative method. In: Ulus Travma Acil Cerrahi Derg. , 15, 2009, pp. 403-405. PMID 19669974
- YI El-Ashaal, AK Al-Olama, FM Abu-Zidan: Trans-anal rectal injuries. (PDF; 57 kB) In: Singapore medical journal , Volume 49, Number 1, January 2008, pp. 54-56, ISSN 0037-5675 . PMID 18204770 .
- OT Dale, NA Smith, RS Rampaul: Tube abuse: a rectal foreign body presenting as chest pain. In: ANZ journal of surgery , Volume 77, Number 12, December 2007, pp. 1131-1132, ISSN 1445-1433 . doi: 10.1111 / j.1445-2197.2007.04339.x . PMID 17973680 .
- JP Lake et al. a .: Management of retained colorectal foreign bodies: predictors of operative intervention. In: Dis Colon Rectum , 47, 2004, pp. 1694-1698. PMID 15540301
- WC Huang, JK Jiang, HS Wang, SH Yang, WS Chen, TC Lin, JK Lin: Retained rectal foreign bodies. In: Journal of the Chinese Medical Association. Volume 66, Number 10, October 2003, pp. 607-612, ISSN 1726-4901 . PMID 14703278 .
- W. Fabian: Foreign bodies in the rectum. Diagnostic and therapeutic aspects. In: Z Gastroenterol. , 29, 1991, pp. 131-133. PMID 2058232
- JR Colthurst: How to remove a rectal foreign body. In: British journal of hospital medicine. Volume 43, Number 5, May 1990, p. 329, ISSN 0007-1064 . PMID 2364225 .
- NK Cooper: Rectal foreign body of record length? In: The Medical journal of Australia , Volume 2, Number 13, December 1979, p. 702, ISSN 0025-729X . PMID 530209 .
- AJ Buzzard, BP Waxman: A long standing, much traveled rectal foreign body. In: The Medical journal of Australia , Volume 1, Number 13, June 1979, p. 600, ISSN 0025-729X . PMID 492002 .
- JE Barone u. a .: Perforations and foreign bodies of the rectum: report of 28 cases. In: Ann Surg. , 184, 1976, pp. 601-604. PMID 984928 , PMC 1345490 (free full text).
- D. Smith: Rectal Foreign Body. In: California and western medicine. Volume 51, Number 5, November 1939, p. 329, ISSN 0093-4038 . PMID 18745388 . PMC 1660156 (free full text).
- HG Pretty: An ink bottle in the rectum. In: Can Med Assoc J. , 31, 1934, pp. 302-303. PMID 20319640 , PMC 403532 (free full text).
- WF Gillespie: A vaseline bottle in the rectum. In: Can Med Assoc J. , 31, 1934, p. 302. PMID 20319639 , PMC 403531 (free full text).
- Fall into the box . In: Der Spiegel . No. 41 , 1991, pp. 317-320 ( online ).
Web links
- X-rays of various rectal foreign bodies at the Charité
- Tanja Walter: Swallowed, pushed and lost - What doctors find in people's bodies. RP Online, September 29, 2015
Individual evidence
- ↑ AA Ayantunde, T. Oke: A review of gastrointestinal foreign bodies. In: Int J Clin Pract 60, 2006, pp. 735-739. PMID 16805760 (Review)
- ↑ a b M. T. Smith, RK Wong: Foreign bodies. In: Gastrointest Endosc Clin N Am 17, 2007, pp. 361-382. PMID 17556153 (Review)
- ↑ BB Pandey et al. a .: Embolic stroke complicating Staphylococcus aureus endocarditis circumstantially linked to rectal trauma from foreign body: a first case report. In: BMC Infectious Diseases 5, 2005, 42. doi: 10.1186 / 1471-2334-5-42 ( Open Access ) PMID 15921523 .
- ↑ a b c D. W. Munter: Foreign Bodies, Rectum. Retrieved September 28, 2009, April 15, 2010.
- ↑ N. Manimaran, M. Shorafa, J. Eccersley: Blow as well as pull: an innovative technique for dealing with a rectal foreign body. In: Colorectal disease: the official journal of the Association of Coloproctology of Great Britain and Ireland Volume 11, Number 3, March 2009, pp. 325-326, ISSN 1463-1318 . doi: 10.1111 / j.1463-1318.2008.01653.x . PMID 18662236 .
- ↑ DL Clarke et al. a .: Colorectal foreign bodies. In: Colorectal Dis 7, 2005, pp. 98-103. PMID 15606596
- ^ LB Stack, DW Munter: Foreign bodies in the gastrointestinal tract. In: Emerg Med Clin North Am 14, 1996, pp. 493-521. PMID 8681881 (Review)
- ^ MA Kurer, C. Davey, S. Khan, S. Chintapatla: Colorectal foreign bodies: a systematic review. In: Colorectal disease: the official journal of the Association of Coloproctology of Great Britain and Ireland Volume 12, Number 9, September 2010, pp. 851-861, ISSN 1463-1318 . doi: 10.1111 / j.1463-1318.2009.02109.x . PMID 19895597 . (Review).
- ↑ a b S. A. Khan u. a .: Munchausen's syndrome presenting as rectal foreign body insertion: a case report. In: Cases J 1, 2008, 243. PMID 18925957 ( Open Access )
- ^ JS Haft, HB Benjamin: Foreign bodies in the rectum: some psychosexual aspects. In: Medical Aspects of Human Sexuality 7, 1973, pp. 74-95.
- ↑ a b c d e f g H. Messmann: Lehratlas der Koloskopie. Georg Thieme Verlag, 2004, ISBN 3-13-136441-6 , p. 219. ISGN restricted preview in the Google book search
- ↑ MC Laitenberger: Clinical and forensic aspects of intestinal intoxicant transport in Hamburg from 1989 to 2004. Dissertation, University of Hamburg, 2005.
- ↑ a b J. S. Cohen and JM Sackier: Management of colorectal foreign bodies. In: J Roy Coll Surg Edin 41, 1996, pp. 312-315. PMID 8908954
- ^ V. Stenz u. a .: Foreign body stories. In: Ther Umsch 65, 2008, pp. 699–702. PMID 19048523
- ↑ M. Kumar: Don't forget your toothbrush! In: British dental journal Volume 191, Number 1, July 2001, pp. 27-28, ISSN 0007-0610 . doi: 10.1038 / sj.bdj.4801082a . PMID 11491473 .
- ↑ F. Nuschler et al. a .: Report on international torture research. ( Memento from July 19, 2011 in the Internet Archive ) (PDF; 4.6 MB) University of Duisburg, 1992.
- ↑ B. Azman, B. ERKU, BH Güvenç: Balloon extraction of a retained rectal foreign body under fluoroscopy, case report and review. In: Pediatric emergency care Volume 25, Number 5, May 2009, pp. 345–347, ISSN 1535-1815 . doi: 10.1097 / PEC.0b013e3181a3494f . PMID 19444034 .
- ↑ a b c d e J. E. Barone u. a .: Perforations and foreign bodies of the rectum: report of 28 cases. In: Ann Surg 184, 1976, pp. 601-604. PMID 984928 , PMC 1345490 (free full text).
- ^ Siu Fai Lo et al .: Traumatic rectal perforation by an eel . In: Surgery , 135.1, 2004, pp. 110-111.
- ↑ a b c d Fall into the box . In: Der Spiegel . No. 41 , 1991, pp. 317-320 ( online ).
- ^ PJ Stephens, ML Taff: Rectal impaction following enema with concrete mix. In: Am J Forensic Med Pathol 8, 1987, pp. 179-182. PMID 3649167 .
- ↑ AG Butters: An unusual rectal injury. In: Br Med J 2, 1955, pp. 602-603. PMID 13240191 , PMC 1980742 (free full text).
- ^ A b c R. P. Mackinnon, G. Fulde: Removing rectal foreign bodies: is the ventouse gender specific? ( Memento of February 18, 2012 in the Internet Archive ) In: Med J Aust 169, 1998, pp. 670-671. PMID 9887927
- ↑ E. Stein: Proctology: Textbook and Atlas. Verlag Springer, 2002, ISBN 3-540-43033-4 , p. 329f. limited preview in Google Book search
- ↑ a b A. TR Axon and M. Classen: Gastroenterological Endoscopy. Georg Thieme Verlag, 2004, ISBN 3-13-132401-5 , pp. 400-401. limited preview in Google Book search
- ↑ D. Hartmann et al. a .: Emergency Endoscopy - Update. In: Gastroenterologie up2date 5, 2009, pp. 321–334. doi: 10.1055 / s-0029-1215318
- ↑ a b c d e f W. C. Huang u. a .: Retained rectal foreign bodies. In: J Chin Med Assoc , 66, 2003, pp. 607-612. PMID 14703278
- ^ A b c T. N. Peet: Removal of impacted rectal foreign body with obstetric forceps. In: British Medical Journal 1976, pp. 500-501. PMID 1252815 , PMC 1638849 (free full text).
- ^ A b S. O. Johnson and TH Hartranft: Nonsurgical removal of a rectal foreign body using a vacuum extractor. Report of a case. In: Dis Colon Rectum 39, 1996, pp. 935-937. PMID 8756851 .
- ↑ H. Bailey and J. Love: A short textbook of surgery. AJH Rains and HD Ritchie (Editors), 16th edition. Lewis Verlag, 1975, p. 1013.
- ↑ a b J. Glaser u. a .: Unusual rectum foreign body: Treatment using argon-beam coagulation. In: Endoscopy 29, 1997, pp. 230-231. doi: 10.1055 / s-2007-1004178 . PMID 9201486 .
- ↑ a b c J. J. Koornstra and RK Weersma: Management of rectal foreign bodies: description of a new technique and clinical practice guidelines. ( Memento of September 19, 2008 in the Internet Archive ) In: World J Gastroenterol 14, 2008, pp. 4403-4406. PMID 18666334
- ^ RM Richter and LM Littman: Endoscopic extraction of an unusual colonic foreign body. In: Gastrointest Endosc 22, 1975, p. 40. PMID 1205104 .
- ↑ L. Wolf and K. Geraci: Colonscopic removal of balloons from the bowel. In: Gastrointest Endosc 24, 1977, p. 41. PMID 892400 .
- ↑ PR Tarnasky u. a .: Colonoscopic diagnosis and treatment of chronic chicken bone perforation of the sigmoid colon. In: Gastrointest Endosc 40, 1994, pp. 373-375. PMID 8056249 .
- ↑ HH Over u. a .: Toothpick impaction: treatment by colonoscopy. In: Endoscopy 29, 1997, pp. S60-S61. PMID 9476787 .
- ↑ JP Hughes et al. a .: Method of removing a hollow object from the rectum. In: Dis Colon Rectum 19, 1976, pp. 44-45. PMID 1248348 .
- ↑ a b c J. C. Kantarian u. a .: Endoscopic retrieval of foreign bodies from the rectum. In: Dis Colon Rectum 30, 1987, pp. 902-904. PMID 3677968 .
- ↑ NR Vemula u. a .: Colonoscopic removal of a foreign body causing colocutaneous fistulas. In: Gastrointest Endosc 28, 1982, pp. 195-196. PMID 7129050 .
- ^ A. Ahmed and SA Cummings: Novel endoscopic approach for removal of a rectal foreign body. In: Gastrointest Endosc 50, 1999, pp. 872-874 PMID 10570362 .
- ^ D. Humes and DN Lobo: Removal of a rectal foreign body by using a Foley catheter passed through a rigid sigmoidoscope. In: Gastrointest Endosc 62, 2005, p. 610. PMID 16185979 .
- ^ S. Feigelson et al. a .: Removal of a large spherical foreign object from the rectum using an obstetric vacuum device: a case report. In: Am Surg 73, 2007, pp. 304-306. PMID 17375796 .
- ↑ JS Haft u. a .: Vaginal vibrator lodged in rectum. In: Br Med J 1, 1976, p. 626. PMID 1252853 , PMC 1639058 (free full text).
- ↑ S. E: Levin u. a .: The use of a curved uterine vulsellum for removal of rectal foreign bodies: Report of a case. In: Diseases of the Colon & Rectum 20, 1977, pp. 532-533. PMID 902553 .
- ↑ D. Siroospour and LR Dragstedt: A large foreign body removed through the anus intact: report of a case. In: Dis Colon Rectum 18, 1975, pp. 616-619. PMID 1181166 .
- ↑ a b D. H. Davies: A chicken bone in the rectum. In: Arch Emerg Med 8, 1991, pp. 62-64. PMID 1854398 , PMC 1285738 (free full text).
- ^ MM Aquino and JW Turner: A simple technique for removing an impacted aerosol-can cap from the rectum. In: Dis Colon Rectum 29, 1986, p. 675. PMID 3757713
- ↑ CJ Couch u. a .: Rectal foreign bodies. In: Med J Aust 144, 1986, pp. 512-515. PMID 3713565
- ↑ RW Graves et al. a .: Anal eroticism: two unusual rectal foreign bodies and their removal. In: South Med J 76, 1983, pp. 677-678. PMID 6844979
- ↑ HI Garber u. a .: Removal of a glass foreign body from the rectum. In: Dis Colon Rectum 24, 1981, p. 323. PMID 7238244
- ↑ H. Sharma et al. a .: A novel technique for nonoperative removal of round rectal foreign bodies. In: Tech Coloproctol 11, 2007, pp. 58-59. PMID 17357869 .
- ↑ M. Yaman et al. a .: Foreign bodies in the rectum. In: Can J Surg 36, 1993, pp. 173-177. PMID 8472230 .
- ^ VS Diwan: Removal of 100-watt electric bulb from rectum. In: Ann Emerg Med 11, 1982, pp. 643-644. PMID 7137678
- ↑ a b D. B. Busch and JR Starling: Rectal foreign bodies: Case Reports and a Comprehensive Review of the World's Literature. In: Surgery 100, 1986, pp. 512-519. PMID 3738771
- ^ AA Jansen: Foreign body in the rectum. In: NZ Med J 70, 1969, pp. 174-175. PMID 5259744
- ^ RL Wigle: Emergency department management of retained rectal foreign bodies. In: Am J Emerg Med 6, 1988, pp. 385-389. PMID 3291887 (Review)
- ↑ JE Losanoff and KT Kjossev: Rectal "oven mitt": the importance of considering a serious underlying injury. In: J Emerg Med 17, 1999, pp. 31-33. PMID 9950383
- ^ CJ Coulson et al. a .: Extraction of a rectal foreign body using an electromagnet. In: International Journal of Colorectal Disease 20, 2005, pp. 194-195. PMID 15322838 .
- ↑ MG Vashist u. a .: Screwing a carrot out of the rectum. In: Indian J Gastroenterol 16, 1997, p. 120. PMID 9248200 .
- ↑ a b S. Nivatvongs u. a .: A simple technique to remove a large object from the rectum. In: J Am Coll Surg 203, 2006, pp. 132-133. PMID 16798498 .
- ^ S. Gopal: A bottle in the rectum. In: J Indian Med Assoc 62, 1974, pp. 24-25. PMID 4839771 .
- ^ SK Clark and ND Karanjia: A cork in a bottle - a simple technique for removal of a rectal foreign body. In: Ann R Coll Surg Engl 85, 2003, p. 282. PMID 12908471 , PMC 1964392 (free full text).
- ↑ T. Konishi et al. a .: Impaction of a rectal foreign body: what is the final approach before surgery? In: Dis Colon Rectum 50, 2007, pp. 262-263. PMID 17164965 .
- ^ J. Ruiz del Castillo et al. a .: Colorectal trauma caused by foreign bodies introduced during sexual activity: diagnosis and management. In: Rev Esp Enferm Dig 93, 2001, pp. 631-634. PMID 11767487 (Review)
- ↑ N. Ikeda et al. a .: Homicide by rectal insertion of a walking stick. In: Nihon Hoigaku Zasshi. Volume 45, 1991, pp. 341-344. PMID 1766149
- ↑ NG Waraich u. a .: Vibrator-induced fatal rectal perforation. In: New Zealand Medical Journal. Volume 120, 2007, p. U2685. PMID 1772649 .
- ↑ RW Byard et al. a .: Unusual fatal mechanisms in nonasphyxial autoerotic death. In: Am Journal of Forensic Medical Pathology. Volume 21, 2000, pp. 65-68. PMID 10739230
- ^ JE Manus: Perforation of the intestine by ingested foreign bodies. In: The American Journal of Surgery 53, 1941, pp. 392-397.
- ↑ RJ Roberge et al. a .: Popcorn primary colonic phytobezoar. In: Ann Emerg Med 17, 1988, pp. 77-79. PMID 3337421
- ↑ A. Eitan et al. a .: Fecal impaction in children: report of 53 cases of rectal seed bezoars. In: J Pediatr Surg 42, 2007, pp. 1114-1117. PMID 17560231 , doi: 10.1016 / j.jpedsurg.2007.01.048 .
- ↑ MS Mirza u. a .: Rectal bezoars due to pumpkin seeds. In: Trop Doct 39, 2009, pp. 54-55. PMID 19211433 .
- ↑ F. Mahjoub et al. a .: Invading plant material appearing as a colonic tumoral mass in a four-year-old girl. In: Trop Doct 39, 2009, pp. 253-254. PMID 19762589 .
- ↑ CB Webb u. a .: Rectal strictures in 19 dogs: 1997-2005. In: JAVMA. Volume 43, 2007, pp. 332-336. PMID 17975215 .
- ^ ND Sargison et al. a .: Intestinal obstruction in a blue-faced Leicester ram associated with a phytobezoar lodged at the pelvic inlet. In: Veterinary Record. Volume 137, 1995, p. 222. PMID 7502475 .
- ↑ HMC Munro, MV Thrusfield: "Battered Pets": Sexual Abuse. (PDF) In: Journal Of Small Animal Practice. Volume 42, 2001, pp. 333-337. PMID 11480898
- ↑ Improbable Research: Winners of the Ig® Nobel Prize. Retrieved April 24, 2010.