title: Management of retained colorectal foreign bodies: predictors of operative intervention.
abstract: OBJECTIVE
  This study was designed to review experience at our hospital with retained colorectal foreign bodies.
  
  
  METHODS
  We reviewed the consultation records at Los Angeles County + University of Southern California General Hospital from October 1993 through October 2002. Ninety-three cases of transanally introduced, retained foreign bodies were identified in 87 patients. Data collected included patient demographics, extraction method, location, size and type of foreign body, and postextraction course.
  
  
  RESULTS
  Of 93 cases reviewed, there were 87 individuals who presented with first-time episodes of having a retained colorectal foreign body. For these patients, bedside extraction was successful in 74 percent. Ultimately, 23 patients were taken to the operating room for removal of their foreign body. In total, 17 examinations under anesthesia and 8 laparotomies were performed (2 patients initially underwent an anesthetized examination before laparotomy). In the eight patients who underwent exploratory laparotomy, only one had successful delivery of the foreign object into the rectum for transanal extraction. The remainder required repair of perforated bowel or retrieval of the foreign body via a colotomy. In our review, a majority of cases had objects retained within the rectum; the rest were located in the sigmoid colon. Fifty-five percent of patients (6/11) presenting with a foreign body in the sigmoid colon required operative intervention vs. 24 percent of patients (17/70) with objects in their rectum (P = 0.04).
  
  
  CONCLUSIONS
  This is the largest single institution series of retained colorectal foreign bodies. Although foreign objects located in the sigmoid colon can be retrieved at the bedside, these cases are more likely to require operative intervention.
authors.affiliation: Department of Colorectal Surgery, Keck School of Medicine, University of Southern California, Los Angeles, California 90033, USA.
authors.forename: Jeffrey P
authors.initials: JP
authors.lastname: Lake
authors.forename: Rahila
authors.initials: R
authors.lastname: Essani
authors.forename: Patrizio
authors.initials: P
authors.lastname: Petrone
authors.forename: Andreas M
authors.initials: AM
authors.lastname: Kaiser
authors.forename: Juan
authors.initials: J
authors.lastname: Asensio
authors.forename: Robert W
authors.initials: RW
authors.lastname: Beart
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001003:Anal Canal / Q000601:surgery; D000768:Anesthesia, General; D003108:Colonic Diseases / Q000473:pathology* / Q000601:surgery*; D005260:Female; D005547:Foreign Bodies; D006801:Humans; D007416:Intestinal Perforation / Q000209:etiology; D007813:Laparotomy; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012002:Rectal Diseases / Q000473:pathology* / Q000601:surgery*; D012189:Retrospective Studies