Management of Vulnating Esophageal Foreign Bodies in Burkina Faso

Introduction: Esophageal foreign bodies (EFB) are a diagnostic and therapeutic emergency because of the serious complications they can cause. Aim: This paper aimed to study the vulnating esophageal foreign bodies in the ENT and Head and Neck Surgery departments of the Yalgado Ouedraogo and Bogodogo University Hospital. Methodology: This was an analytic cross-sectional study with retrospective data collection over 10 years (2012-2021). Results: We collected 91 cases of vulnating esophageal foreign bodies, i.e. 9.1 cases/year (4.7%). The mean age of the patients was 14 ± 19 years. The sex ratio was 1.6. The circumstances of occurrence were dominated by accidental ingestion of vulnating esophageal foreign bodies (98.9%). The average time to consultation was 7.5 hours. Dysphagia was the dominant symptom (64.8%). Cervico-thoracic radiography found dual contour radiopaque images in 71.4%. Esophagoscopy with rigid tube was performed in 97.8%. The average time for extraction of the vulnating esophageal foreign bodies was 8 hours. Vulnerating esophageal foreign bodies were non-organic in 84.6%. The button cell represented 64.8%. Their location was cervical in 61.5% intraoperatively. The lesion assessment found ulcerative lesions in 42.9% (p Conclusion: Vulnating esophageal foreign bodies are relatively frequent in our ENT practice. Although their diagnosis is often easy, their treatment is still difficult and requires multidisciplinary management. Thus, for us, prevention remains the first effective weapon.

Management of Traumatic Foreign Bodies of the Upper Aerodigestive Tract in Children with Limited Diagnostic Resources at the Pediatric University Hospital of Central African Republic of Bangui

Accidental acute upper airway obstruction (UAO) is a common situation in pediatric emergencies. It is a source of morbidity and even mortality, particularly in children under 3 years of age. We report a clinical case of traumatic foreign body injury to the upper aerodigestive tract in a 7-year-old girl following a play accident.

General anesthesia with endotracheal intubation ensures the quick removal of magnetic foreign bodies:A case report

BACKGROUND The incidence of ingestion of magnetic foreign bodies in the gastrointestinal tract has been increasing year by year.Due to their strong magnetic attraction,if multiple gastrointestinal foreign bodies enter the small intestine,it can lead to serious complications such as intestinal perforation,necrosis,torsion,and bleeding.Severe cases require surgical intervention.CASE SUMMARY We report a 6-year-old child who accidentally swallowed multiple magnetic balls.Under timely and safe anesthesia,the magnetic balls were quickly removed through gastroscopy before entering the small intestine.CONCLUSION General anesthesia with endotracheal intubation can ensure full anesthesia under the condition of fasting for less than 6 h.In order to prevent magnetic foreign bodies from entering the small intestine,timely and effective measures must be taken to remove the foreign bodies.

Characteristics of Ent Foreign Bodies in a Hospital at Cotonou, Benin

Introduction: Foreign bodies (FB) can constitute a life-threatening emergency by their nature or their location. The objective of this study was to describe the socio-demographic, diagnostic and therapeutic characteristics of FB in the ENT department of CHUZ-Suru Léré in Cotonou. Methods: This was a descriptive and analytical cross-sectional study, with retrospective data collection spanning a period of ten (10) years from January 1st, 2013 to December 31st, 2022. Patients of all ages seen in consultations in the ENT and CCF department of the CHUZ-Suru Léré during the study period and meeting the inclusion criteria were taken into account. Results: During the study period, 1810 cases of FB were collected among the 13,947 consultations, i.e. a hospital frequency of 12.98%. The age of the patients varied from 19 days to 94 years with a predominance of children under 10 years (60.2%). The sex ratio (male/female) was 1.13. The duration between the onset of FB and the medical consultation was greater than 72 hours in 88.49% of cases. The circumstances of occurrence of FB were unknown in 86.34% of cases. The external acoustic meatus was the most common location (90.22%). The nature of FB was inorganic in 86.80% of cases dominated by earwax plugs (77.90%), and organic FB in 7.96% of cases dominated by cotton (3.98%). All FB were extracted by the route of introduction except one case. The extraction was performed most often in the consultation chair (97.07% of cases). The evolution was generally favorable (99.94%). Conclusion: ENT foreign bodies are a frequent reason for consultation and mainly affect male children. They are usually inorganic. Evolution is generally favorable after extraction. Prevention remains the best solution.

Misdiagnosis of food-borne foreign bodies outside of the digestive tract on magnetic resonance imaging:Two case reports

BACKGROUND Patients with foreign bodies in the digestive tract are often encountered,but complete penetration of a foreign body through the gastrointestinal tract is rare,and the choice of imaging method is very important.Improper selection may lead to missed diagnosis or misdiagnosis.CASE SUMMARY An 81-year-old man was diagnosed as having a liver malignancy after he took magnetic resonance imaging and positron emission tomography/computed tomography(CT)examinations.The pain improved after the patient accepted gamma knife treatment.However,he was admitted to our hospital 2 mo later due to fever and abdominal pain.This time,he received a contrast-enhanced CT scan,which showed fish-boon-like foreign bodies in the liver with peripheral abscess formation,then he went to the superior hospital for surgery.It lasted for more than 2 mo from the onset of the disease to the surgical treatment.A 43-year-old woman with a 1 mo history of a perianal mass with no obvious pain or discomfort was diagnosed as having an anal fistula with the formation of a local small abscess cavity.Clinical perianal abscess surgery was performed,and fish bone foreign body was found in perianal soft tissue during the operation.CONCLUSION For patients with pain symptoms,the possibility of foreign body perforation should be considered.Magnetic resonance imaging is not comprehensive and that a plain computed tomography scan of the pain area is necessary.

Clinical features,radiological imaging,and treatment strategies of nonmetallic intraorbital foreign bodies:a retrospective analysis

AIM:To provide comprehensive data on nonmetallic intraorbital foreign bodies(IOFBs)by summarizing and analyzing material types,clinical manifestations,imaging features,and treatment strategies.METHODS:Totally 28 nonmetallic IOFB cases treated at Shengjing Hospital of China Medical University from 2012 to 2020 were retrospectively reviewed.The types of foreign bodies,clinical features,imaging manifestations,and treatment outcomes were analyzed.RESULTS:Among all cases,67.8%(19/28)of the foreign bodies were organic.The top three entrances were the upper eyelid skin(7/28),lower fornix conjunctiva(6/28),and lower eyelid skin(4/28).In most cases(11/28,39.3%),foreign bodies remained in the medial orbits.The major clinical manifestations included eyelid redness and swelling(20/28,71.4%),conjunctival congestion and edema(17/28,60.7%),and ophthalmoptosis(15/28,53.6%).Infection was the main complication,which occurred in 57.1%(16/28)of all cases.Computerized tomography(CT)values differed for different foreign bodies and varied in the different periods after injury.The plant-and grease-derived foreign bodies and the surrounding pus cysts showed different signals on magnetic resonance imaging(MRI).The prognosis varied with different foreign body types,surgery timing,and intraoperative management.CONCLUSION:The majority of nonmetallic IOFBs are organic and often remain in the superior,medial,and inferior areas of the orbit.Clinical manifestations vary owing to their different textures.CT and MRI facilitate the identification of foreign body materials.Plant-derived foreign bodies should be completely removed,and surgical treatment is a complicated process.

Bedside ultrasound-guided water injection assists endoscopically treatment in esophageal perforation caused by foreign bodies: A case report

BACKGROUND Fishbone migration from the esophagus to the neck is relatively uncommon in clinical practice.Several complications secondary to esophageal perforation after ingestion of a fishbone have been described in the literature.Typically,a fishbone is detected and diagnosed by imaging examination and is usually removed by a neck incision.CASE SUMMARY Herein,we report a case of a 76-year-old patient with a fishbone in the neck that had migrated from the esophagus and that was in close proximity to the common carotid artery,and the patient experienced dysphagia.An endoscopically-guided neck incision was made over the insertion point in the esophagus,but the surgery failed due to having a blurred image at the insertion site during the operation.After injection of normal saline laterally to the fishbone in the neck under ultrasound guidance,the purulent fluid outflowed to the piriform recess along the sinus tract.With endoscopic guidance,the position of the fish bone was precisely located along the direction of liquid outflow,the sinus tract was separated,and the fish bone was removed.To the best of our knowledge,this is the first case report describing bedside ultrasound-guided water injection positioning combined with endoscopy in the treatment of a cervical esophageal perforation with an abscess.CONCLUSION In conclusion,the fishbone could be located by the water injection method under the guidance of ultrasound and could be accurately located along the outflow direction of the purulent fluid of the sinus by the endoscope and was removed by incising the sinus.This method can be a nonoperative treatment option for foreign body-induced esophageal perforation.

Cap-assisted endoscopy for esophageal foreign bodies:A metaanalysis

BACKGROUND Esophageal foreign bodies are common around the world.Newer approaches,such as cap-assisted endoscopy,have been introduced as an alternative to conventional methods.Therefore,we performed a meta-analysis ono cap-assisted endoscopy versus conventional endoscopy for removal of esophageal foreign bodies.AIM To investigated the effectiveness of cap-assisted endoscopy with conventional endoscopy.METHODS An extensive literature search was performed(December 2021).For esophageal foreign body removal,cap-assisted endoscopy was compared to conventional endoscopy for procedure time,technical success of the procedure,time of foreign body retrieval,en bloc removal,and adverse event rate using odds ratio and mean difference.RESULTS Six studies met the inclusion criteria(n=1305).Higher odds of technical success(P=0.002)and en bloc removal(P<0.01)and lower odds of adverse events(P=0.02)and foreign body removal time(P<0.01)were observed with cap-assisted endoscopy as compared to conventional techniques.CONCLUSION For esophageal foreign bodies,the technique of cap-assisted endoscopy demonstrated increased en bloc removal and technical success with decreased time and adverse events as compared to conventional techniques.

Accidental ingestion of foreign bodies/harmful materials in children from Bahrain:A retrospective cohort study

BACKGROUND Children like to discover their environment by putting substances in their mouths.This behavior puts them at risk of accidentally ingesting foreign bodies(FBs)or harmful materials,which can cause serious morbidities.AIM To study the clinical characteristics,diagnosis,complications,management,and outcomes of accidental ingestion of FBs,caustics,and medications in children.METHODS We conducted a retrospective cohort study of all children admitted for accidental ingestion to the Department of Pediatrics,Salmaniya Medical Complex,Bahrain,between 2011 and 2021.Demographic data,type of FB/harmful material ingested,and investigations used for diagnosis and management were recorded.The patients were divided into three groups based on the type of ingested material(FBs,caustics,and medications).The three groups were compared based on patient demographics,socioeconomic status(SES),symptoms,ingestion scenario,endoscopic and surgical complications,management,and outcomes.The FB anatomical location was categorized as the esophagus,stomach,and bowel and compared with respect to symptoms.The Fisher’s exact,Pearson’s χ^(2),Mann-Whitney U,and Kruskal-Wallis tests were used for comparison.RESULTS A total of 161 accidental ingestion episodes were documented in 153 children.Most children were boys(n=85,55.6%),with a median age of 2.8(interquartile range:1.8-4.4)years.Most participants ingested FBs(n=108,70.6%),31(20.3%)ingested caustics,and the remaining 14(9.2%)ingested medications.Patients with caustic ingestion were younger at the time of presentation(P<0.001)and were more symptomatic(n=26/31,89.7%)than those who ingested medications(n=8/14,57.1%)or FBs(n=52/108,48.6%)(P<0.001).The caustic group had more vomiting(P<0.001)and coughing(P=0.029)than the other groups.Most FB ingestions were asymptomatic(n=55/108,51.4%).In terms of FB location,most esophageal FBs were symptomatic(n=14/16,87.5%),whereas most gastric(n=34/56,60.7%)and intestinal FBs(n=19/32,59.4%)were asymptomatic(P=0.002).Battery ingestion was the most common(n=49,32%).Unsafe toys were the main source of batteries(n=22/43,51.2%).Most episodes occurred while playing(n=49/131,37.4%)or when they were unwitnessed(n=78,57.4%).FBs were ingested more while playing(P<0.001),caustic ingestion was mainly due to unsafe storage(P<0.001),and medication ingestion was mostly due to a missing object(P<0.001).Girls ingested more jewelry items than boys(P=0.006).The stomach was the common location of FB lodgment,both radiologically(n=54/123,43.9%)and endoscopically(n=31/91,34%).Of 107/108(99.1%)patients with FB ingestion,spontaneous passage was noted in 54(35.5%),endoscopic removal in 46(30.3%),laparotomy in 5(3.3%)after magnet ingestion,and direct laryngoscopy in 2(1.3%).Pharmacological therapy was required for 105(70.9%)patients;79/105(75.2%)in the FB group,22/29(75.9%)in the caustic group,and 4/14(28.8%)in the medication group(P=0.001).Omeprazole was the commonly used(n=58;37.9%)and was used more in the caustic group(n=19/28,67.9%)than in the other groups(P=0.001).Endoscopic and surgical complications were detected in 39/148(26.4%)patients.The caustic group had more complications than the other groups(P=0.036).Gastrointestinal perforation developed in the FB group only(n=5,3.4%)and was more with magnet ingestion(n=4)than with other FBs(P<0.001).In patients with FB ingestion,patients aged<1 year(P=0.042),those with middle or low SES(P=0.028),and those with more symptoms at presentation(P=0.027)had more complications.Patients with complications had longer hospital stays(P<0.001)than those without.CONCLUSION Accidental ingestion in children is a serious condition.Symptomatic infants from middle or low SES families have the highest morbidity.Prevention through parental education and government legislation is crucial.

Endoscopic retrieval of 28 foreign bodies in a 100-year-old female after attempted suicide

Foreign body ingestion is a common emergency situation in children with one or a few objects having been ingested. Here we report our experience using endo-scopic retrieval in a female centenarian with dyspnea and foreign bodies in the esophagus. She attempted suicide by swallowing 26 coins and two other foreign bodies. A gastroscope was used to remove all foreign bodies in the lower esophagus. In total, 26 coins, one ferrous ring and one cylindrical plastic object were retrieved. To our knowledge, this is the first clinical report on retrieval of so many foreign bodies in a single case.

Airway foreign bodies: A critical review for a common pediatric emergency

BACKGROUND:Airway foreign bodies(AFBs)is an interdisciplinary area between emergency medicine,pediatrics and otolaryngology.It is a life-threatening condition that is not infrequently seen;however,it is poorly covered in medical literature.Accidental aspiration of an element into airways is a widespread clinical scenario among children under 3 years,predominantly males.Moreover,it is the leading cause of infantile deaths and the fourth one among preschool children.DATA RESOURCES:A systemic search was conducted in July 2015 using Pub Med/Pub Med Central Database of The National Center for Biotechnology Information(NCBI)(http://www.ncbi.nlm.nih.gov/).A total of 1 767 articles were identified and most of them were meta-analyses,systematic reviews,and case series.Those thoroughly discussing assessment and management of AFBs were retrieved.RESULTS:AFBs episodes may be either witnessed or missed.Presence of a witness for the inhalation is diagnostic.The later usually present with persistent active cough.A classical triad of paroxysmal cough,wheezing,and dyspnoea/decreased air entry was reported,though many presentations have inconsistent findings.Hence,diagnosis requires high index of clinical suspicion.Flexible fibro-optic bronchoscopy is the gold standard of diagnosis,whereas inhaled objects are best retrieved by rigid bronchoscopes.CONCLUSIONS:Close supervision of pediatrics is the hallmark of prevention.Caregivers should ensure a safe surrounding milieu,including the toys their offspring play with.Immediate complications result from direct obstruction or injury by the inhaled object.Alternatively,prolonged lodging traps air and induces inflammatory response causing atelectesis and pneumonia,respectively.

Clinical characteristics and prognostic factors for visual outcome in 669 patients with intraocular foreign bodies

AIM: To describe the clinical characteristics and analyze prognostic factors that influence visual outcome in 669 patients with intraocular foreign bodies(IOFBs).METHODS: Medical records of 669 patients with IOFBs from West China Hospital were reviewed. Best corrected visual acuity(BCVA) values were recorded using standard Snellen acuity chart and were converted to logarithm of the minimum angle of resolution(log MAR) scale for statistical analysis. The visual outcome was defined by the final BCVA(excellent visual outcome: final BCVA of 20/40 or better;poor visual outcome: final BCVA less than 20/200). Statistical analysis of collected data was performed using IBM SPSS Statistics version 23. A 2-tailed P value of less than 0.05 was considered statistically significant throughout the study. RESULTS: The average age ranged from 1 to 79 years old(mean age, 34.8±12.7 SD) and the majority of patients were men(626, 93.6%). The major cause of ocular injury was hammering(383, 57.2%). Almost all the patients(97.8%) underwent surgeries(97.8%) and the average time interval between injury and surgery was 26.4±322.3 d(0-7300), while 327 patients received surgeries within 24 h(48.9%) and 590 patients received surgeries within seven days(88.2%) after IOFBs injury. The poor BCVA was associated with older age(P=0.013), larger IOFBs size(P<0.001), presence of complications(P<0.001) and worse presenting BCVA(P<0.001). On the contrary, younger age(P=0.005), smaller IOFBs size(P<0.001), absence of complications(P<0.001) and better presenting BCVA(P<0.001) were considered to relate to excellent BCVA.CONCLUSION: Multiple prognostic factors may influence the final visual outcome, including age, size of IOFBs, complications and presenting BCVA. Meanwhile, further education and promotion on eye protection should be taken for the improvement on self-protection and selfhealth awareness.

Voluntary Ingestion of a Cola Nut Stuck into the Esophagus: An Unusual Foreign Body (FB)

The cola nut (Cola nitida), is a rare foreign body. Its voluntary ingestion, for ritual practices, is a situation of exceptional occurrence, and jamming it in the esophagus is a therapeutic emergency. Here, we report the case of an adult patient, with a cola nut measuring 3 cm in diameter swallowed for a ritual purpose, jammed at the bottom of his esophagus. A surgical extraction was performed by gastrostomy after a failed attempt of endoscopic extraction. There ensued a complication of a left-esophageal fistula. The various aspects of this case are analyzed in the light of the literature review.

Endoscopic Management of Foreign Bodies in the Upper Gastrointestinal Tract in Yaoundé(Cameroon)

Background/Aims: Foreign body (FB) ingestion is a common clinical situation. In some cases, it could be life-threatening, requiring interventional digestive endoscopy. Knowing the main FBs observed could help to prevent their ingestion or to improve management. The aim of this study is to report the results of upper digestive endoscopies performed for ingestion of FBs in Yaoundé (Cameroon). Methods: We recorded all patients who did a gastroscopy for FB ingestion from January 2000 to April 2020 in three medical centers of Yaoundé. We collected data concerning the socio-demographic characteristics of patients, foreign body type, endoscopic management and outcome. Results: A total of 9380 upper digestive endoscopies were performed, with 51 FBs ingestion (0.54%). Male were 27 (52.9%). The mean age was 25.8 ± 22.3 years (8 months to 75 years). Coins were the most frequent FB (23.5%), only observed in children, followed by fishbones (17.6%), only observed in adults. We also observed dental wears (11.8%), metallic objects (11.8%), non-metallic objects (3.9%), batteries (3.9%), toothpick (2%), packet of tablets (2%), and bezoars (2%). The FB was unknown at 21.6%. The most frequent localization was the esophagus in 29/36 patients (80.5%). Endoscopic removal was a success in 35/36 patients (97.2%). A surgery has been performed on one patient. We didn’t register any death. Conclusion: Most common FBs ingested in Yaoundé are coins and fishbones. The upper digestive endoscopy has a high success rate.

Foreign Bodies from the Upper Digestive Tract at University Hospital Center Gabriel Touré: The Contribution of Digestive Endoscopy

Foreign bodies ingestion is regularly observed in gastroenterology context. The evolution is favorable with early extraction. Our main objective was to evaluate foreign bodies managed in digestive endoscopic center of University hospital center Gabriel Touré. The study was retrospective from January 2007 to October 2017 in the endoscopic center of the service of gastroenterology of University hospital center Gabriel Touré and concerned the patients who have been addressed at this center for foreign bodies. We collated 44 patients who ingested foreign bodies among 2750 digestive endoscopies, that is to say, a frequency of 0.16%. In patient’s history, we found caustic obstruction in 2.3% of patients. The foreign body ingestion was accidental in 97.7% of cases. Pieces of money were more frequent (54.4%). In 86.4%, the foreign bodies were into the esophagus. Upper digestive endoscopy performed foreign bodies extraction in 88.6 of cases. In 9.1%, the elimination was spontaneous on 72 hours. Surgeon was indicated in 2.3% of patients. The evolution was favorable in 97.7% of patients. One patient died by digestive bleeding. Conclusion: Foreign bodies ingestion is frequent in children. The upper digestive endoscopy can do the diagnosis and the management.

Endoscopic management of foreign bodies in the upper gastrointestinal tract:A review

Foreign body ingestion is a common condition, es-pecially among children who represent 80% of these emergencies. The most frequently ingested foreign bodies in children are coins, toys, magnets and batter-ies. Most foreign body ingestions in adults occur while eating, leading to either bone or meat bolus impaction. Flexible endoscopy is the therapeutic method of choice for relieving food impaction and removing true foreign bodies with a success rate of over 95% and with mini-mal complications. This review describes a comprehen-sive approach towards patients presenting with foreign body ingestion. Recommendations are based on a review of the literature and extensive personal experi-ence.

Risk factors for complications associated with upper gastrointestinal foreign bodies

AIM: To investigate predictive risk factors associated with complications in the endoscopic removal of foreign bodies from the upper gastrointestinal tract.METHODS: We retrospectively reviewed the medical records of 194 patients with a diagnosis of foreign body impaction in the upper gastrointestinal tract,confirmed by endoscopy,at two university hospital in South Korea.Patient demographic data,including age,gender,intention to ingestion,symptoms at admission,and comorbidities,were collected.Clinical features of the foreign bodies,such as type,size,sharpness of edges,number,and location,were analyzed.Endoscopic data those were analyzed included duration of foreign body impaction,duration of endoscopic performance,endoscopic device,days of hospitalization,complication rate,30-d mortality rate,and the number of operationsrelated to foreign body removal.RESULTS: The types of upper gastrointestinal foreign bodies included fish bones,drugs,shells,meat,metal,and animal bones.The locations of impacted foreign bodies were the upper esophagus(57.2%),mid esophagus(28.4%),stomach(10.8%),and lower esophagus(3.6%).The median size of the foreign bodies was 26.2 ± 16.7 mm.Among 194 patients,endoscopic removal was achieved in 189,and complications developed in 51 patients(26.9%).Significant complications associated with foreign body impaction and removal included deep lacerations with minor bleeding(n = 31,16%),ulcer(n = 11,5.7%),perforation(n = 3,1.5%),and abscess(n = 1,0.5%).Four patients underwent operations because of incomplete endoscopic foreign body extraction.In multivariate analyses,risk factors for endoscopic complications and failure were sharpness(HR = 2.48,95%CI: 1.07-5.72; P = 0.034) and a greater than 12-h duration of impaction(HR = 2.42,95%CI: 1.12-5.25,P = 0.025).CONCLUSION: In cases of longer than 12 h since foreign body ingestion or sharp-pointed objects,rapid endoscopic intervention should be provided in patients with ingested foreign bodies.

Emergency admissions due to swallowed foreign bodies in adults

AIM:To study a retrospective analysis of patients who presented to the emergency departments(ED)with complaints related to foreign body ingestions.METHODS:Patients older than 16 years of age who presented to the ED between January 1stand December 31stof 2010 with complaints related to swallowed foreign bodies were identified from electronic health records and patient charts.RESULTS:A total of 100 patients presented with a complaint of foreign body ingestion during the study period.Overall,an X-ray was performed on 75 patients,and a fiberoptic evaluation was performed on45 patients.A foreign body was detected in 46(46%)patients.The diagnostic yield of the X-ray was 27(36%)out of 75 patients,while the diagnostic yield of the fiberoptic evaluations was 21(47%)out of 45 patients.The detected foreign bodies were mostly located in the esophagus(17 out of 46 foreign bodies detected).When the types of ingested foreign bodies were evaluated,52(52%)patients reported ingesting food,and19(19%)patients reported swallowing pins.An X-ray was performed on 33 patients with accidental food ingestions but yielded a positive result in only two cases.In 12 out of 21 patients with accidental food ingestion who underwent fiberoptic evaluation,the foreign material was detected and removed.CONCLUSION:Plain radiography is helpful in the localization of radiopaque swollen foreign bodies,while fiberoptic methods are useful as both diagnostic and therapeutic tools,regardless of radiopacity.

Increasing trend in retained rectal foreign bodies

AIM To highlight the rising trend in hospital presentation of foreign bodies retained in the rectum over a 5-year period.METHODS Retrospective review of the cases of retained rectal foreign bodies between 2008 and 2012 was performed.Patients' clinical data and yearly case presentation with data relating to hospital episodes were collected.Data analysis was by SPSS Inc.Chicago,IL,United States.RESULTS Twenty-five patients presented over a 5-year period with a mean age of 39(17-62) years and M: F ratio of 2:1.A progressive rise in cases was noted from 2008 to 2012 with 3,4,4,6,8 recorded patients per year respectively.The majority of the impacted rectal objects were used for self-/partner-eroticism.The commonest retained foreign bodies were sex vibrators and dildos.Ninty-six percent of the patients required extraction while one passed spontaneously.Two and three patients had retrieval in the Emergency Department and on the ward respectively while 19 patients needed examination under anaesthesia for extraction.The mean hospital stay was 19(2-38) h.Associated psychosocial issues included depression,deliberate self-harm,illicit drug abuse,anxiety and alcoholism.There were no psychosocial problems identified in 15 patients.CONCLUSION There is a progressive rise in hospital presentation of impacted rectal foreign bodies with increasing use of different objects for sexual arousal.

Management of rectal foreign bodies: Description of a new technique and clinical practice guidelines

A number of techniques have been described to remove rectal foreign bodies. In this report, a novel endoscopic technique using a pneumatic dilatation balloon normally used in achalasia patients is presented. In addition, a systematic review of the literature was performed for non-operative methods to remove foreign bodies from the rectum. These results are summarised, presented as a practical at-a- glance overview and a flow chart is offered to guide the clinician in treatment decisions. The design of the flow chart was based on the aims to treat the patient preferably on an outpatient basis with minimally invasive techniques and if possible under conscious sedation rather than general anaesthesia.