Rectal foreign bodies: national outcomes after the operating room
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ORIGINAL ARTICLE
Rectal foreign bodies: national outcomes after the operating room Joseph G. Brungardt 1 & Ryan J. O’Dell 1 & Stephen R. Eaton 1 & Ashley W. Bennett 1 Accepted: 17 September 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose Rectal foreign bodies can pose a unique problem to the acute care surgeon or emergency room physician. Little data exists on the patient with such a diagnosis, outside of case reports, and institutional cohorts. This study describes demographics and outcomes for this patient population. Methods An analysis of the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database (2015 to 2018) was performed, capturing patients with a postoperative diagnosis of foreign body of the anus or rectum. Patients were stratified into two groups: those who underwent removal under anesthesia (EUA) and those who required surgical removal. Baseline demographics and outcomes were compared and described. Results A total of 109 patients were included in the study. The average age was 49.29 ± 14.63 years. The majority of the population was male (92.66%) and white (78.90%). Demographics and preoperative variables were clinically similar between patients receiving an EUA or an operation. Length of stay was longer in patients receiving an operation (4.84 ± 3.27 versus 1.39 ± 3.20 days in those receiving an EUA, p < 0.0001). About 97.24% of the population discharged to their home residence. Conclusions This study describes a population of patients admitted for retained foreign body of the rectum, in a population larger than that can be described in a typical institutional review. EUA can be a safe approach to foreign body removal, with laparotomy carrying the typical risks of surgery. This population requires further study to identify the mechanisms and risk factors for alimentary tract injury to reduce operative interventions and improve outcomes. Keywords Rectal foreign body . Fecal diversion . Ostomy
Introduction Injury to the rectum and colon, including the anus, often pose a therapeutic dilemma to the practicing surgeon. These are often approached diligently, with the treatment options being weighed of watchful waiting, primary repair, or possibly diversion, depending on the level and extent of injury [1]. Rectal foreign bodies, typically retained after sexual activity, are an infrequent, but often discussed cause of rectal injury [2]. The demographics have been reported previously, with surgical management described for full-thickness injury [3]. Literature is scarce on this diagnosis, outside of case reports, and institutional cohorts. The circumstances surrounding the foreign bodies seem to typically be sexual
* Joseph G. Brungardt [email protected] 1
Department of Surgery, The University of Kansas, 4000 Cambridge, M/S 2005, Kansas City, KS 66160, USA
stimulation, with other causes being attributed to assault, home therapeutics, falling, or “mule” smuggling. The objects themselves are not always benign, ranging from
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