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02-06-2022 | Septicemia | Original Article

Proposal of an algorithm for the management of rectally inserted foreign bodies: a surgical single-center experience with review of the literature

Authors: Stefan Fritz, Hansjörg Killguss, André Schaudt, Christof M. Sommer, Götz M. Richter, Sebastian Belle, Christoph Reissfelder, Steffan Loff, Jörg Köninger

Published in: Langenbeck's Archives of Surgery | Issue 6/2022

Abstract

Background

Retained rectal foreign bodies (RFBs) are uncommon clinical findings. Although the management of RFBs is rarely reported in the literature, clinicians regularly face this issue. To date, there is no standardized management of RFBs. The aim of the present study was to evaluate our own data and subsequently develop a treatment algorithm.

Methods

All consecutive patients who presented between January 2006 and December 2019 with rectally inserted RFBs at the emergency department of the Klinikum Stuttgart, Germany, were retrospectively identified. Clinicopathologic features, management, complications, and outcomes were assessed. Based on this experience, a treatment algorithm was developed.

Results

A total of 69 presentations with rectally inserted RFBs were documented in 57 patients. In 23/69 cases (33.3%), the RFB was removed transanally by the emergency physician either digitally (n = 14) or with the help of a rigid rectoscope (n = 8) or a colonoscope (n = 1). In 46/69 cases (66.7%), the RFB was removed in the operation theater under general anesthesia with muscle relaxation. Among these, 11/46 patients (23.9%) underwent abdominal surgery, either for manual extraction of the RFB (n = 9) or to exclude a bowel perforation (n = 2). Surgical complications occurred in 3/11 patients. One patient with rectal perforation developed pelvic sepsis and underwent abdominoperineal extirpation in the further clinical course.

Conclusion

The management of RFBs can be challenging and includes a wide range of options from removal without further intervention to abdominoperineal extirpation in cases of pelvic sepsis. Whenever possible, RFBs should obligatorily be managed in specialized colorectal centers following a clear treatment algorithm.

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Title: Proposal of an algorithm for the management of rectally inserted foreign bodies: a surgical single-center experience with review of the literature
Authors: Stefan Fritz
Hansjörg Killguss
André Schaudt
Christof M. Sommer
Götz M. Richter
Sebastian Belle
Christoph Reissfelder
Steffan Loff
Jörg Köninger
Publication date: 02-06-2022
Publisher: Springer Berlin Heidelberg
Keywords: Septicemia
Septicemia
Published in: Langenbeck's Archives of Surgery / Issue 6/2022
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI: https://doi.org/10.1007/s00423-022-02571-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Proposal of an algorithm for the management of rectally inserted foreign bodies: a surgical single-center experience with review of the literature

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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