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CASE REPORT
A play that went wrong: Unique presentation of bowel perforation from an unusually large per-rectal foreign body
  1. Saad Ikram1,
  2. Shailendra Singh1,
  3. Ramana Kallam2,
  4. Ajay Dabra3
  1. 1General Surgery, Northern Lincolnshire and Goole Hospitals NHS Foundation Trust, Scunthorpe, UK
  2. 2Colorectal Surgery, Northern Lincolnshire and Goole Hospitals NHS Foundation Trust, Scunthorpe, UK
  3. 3Department of Radiology, Northern Lincolnshire and Goole Hospitals NHS Foundation Trust, Scunthorpe, UK
  1. Correspondence to Dr Saad Ikram, drsikram{at}hotmail.com

Summary

Colorectal foreign bodies (FBs) are not unheard of in the province of surgery. They are commonly seen in men ranging from 20 to 90 years of age with a bimodal age distribution. A variety of objects have been described and reported in literature. Management involves a complete history and examination followed by the necessary investigations. Most of the time they can be removed at bedside with some manipulation techniques employing the use of some ingenious devices and/or endoscopy for adamant objects. But persistent FBs or those that are high in the rectum or those that present with complications will require operative management. We present a case of a 77 cm long FB inserted rectally for sexual gratification in a male patient, which caused a large bowel perforation, ending high intra-abdominally at the level of the spleen and diaphragm after traversing the entire abdominal cavity and requiring a laparotomy for removal.

  • gastrointestinal surgery
  • trauma

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Footnotes

  • Contributors Patient was first seen, clinically assessed and prepared for surgery by SS. RK performed the surgery and was involved in the postoperative care and follow-up. SI was involved in post operative care, conceived the write-up and performed the literature search and manuscript preparation. AD was involved in the radiological findings, images and advice in preparation of the manuscript. All authors read and approved the manuscript for submission.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.