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MANAGEMENT OF ANORECTAL FOREIGN BODIES: A CAUSE OF OBSCURE ANAL PAIN
Author(s) -
Ooi BoonSwee,
Ho YikHong,
Eu KongWeng,
Nyam Denis,
Leong Adrian,
SeowChoen Francis
Publication year - 1998
Publication title -
australian and new zealand journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.111
H-Index - 51
eISSN - 1445-2197
pISSN - 0004-8682
DOI - 10.1111/j.1445-2197.1998.tb04701.x
Subject(s) - medicine , surgery , laparotomy , foreign body , sedation , general anaesthesia , abdominal pain
Background : Few patients with anorectal foreign bodies will freely admit to transanal introduction. The results of long‐term follow‐up in these patients have been sparse. Methods : Data from April 1989 to April 1997 were extracted from a prospective computerized database. The clinical features and the results of a departmental management protocol for anorectal foreign bodies were analysed. In addition, long‐term outcomes were obtained by telephone interview. Results : Thirty patients (25 men, 5 women) with a mean age of 46 (range 16–72) years) were treated for this condition. While 10 patients (33.3%) admitted to transanal insertion, the remaining 20 (66.7%) complained of anal pain. Among the latter, the foreign body was subsequently found on routine digital rectal examination in nine patients (45%), on X‐ray in nine (45%) and it was passed out unexpectedly after fleet enema in two (10%). Factors which raised suspicion for X‐rays included atypical gender behaviour, lax anal sphincters and bloody or mucoid rectal discharge. Transanal recovery was successful with sedation in 12 (40%), general anaesthesia in 13 (43.3%), and laparotomy was needed in three (10%; which included one perforated bowel at presentation). There were two complications (6.7%; one minor rectal abrasion and one bronchopneumonia). There was no long‐term faecal incontinence or re‐impaction of foreign bodies at 63 (range 8–96) months of follow‐up. Conclusions : Foreign bodies should be suspected in patients with obscure anal pain. Judicious transanal extraction under sedation or general anaesthesia was usually successful with minimal short‐and long‐term complications.