title: Successful Transanal Removal of a Rectal Foreign Body by Abdominal Compression under Endoscopic and X-Ray Fluoroscopic Observation: A Case Report.
abstract: We occasionally encounter patients with various types of rectal foreign bodies. When too large to grasp, transanal removal can be difficult. Here, we report a case of successful manual transanal removal of an 18 × 4 × 4 cm silicon rod without complications. A 50-year-old male came to the emergency department of our hospital 12 h after transanal insertion of a whole silicon rod. An abdominal examination showed no evidence of peritonitis, while X-ray and computed tomography findings revealed a large foreign body in the rectum, without any sign of perforation. Initially, we attempted removal using an endoscopy procedure with conventional endoscopic instruments, including a snare and grasp forceps, though we failed because of the large size. Next, we manually compressed the foreign body from the abdominal wall under endoscopic and X-ray fluoroscopic observation, and successfully removed it in a transanal manner without complications. Endoscopic and X-ray fluoroscopic assistance were helpful to guide the direction and angle of abdominal compression in this case.
authors.affiliation: Department of Gastroenterology and Hepatology, Shimane University School of Medicine, Izumo, Japan.
authors.forename: Hironobu
authors.initials: H
authors.lastname: Mikami
authors.affiliation: Department of Gastroenterology and Hepatology, Shimane University School of Medicine, Izumo, Japan.
authors.forename: Norihisa
authors.initials: N
authors.lastname: Ishimura
authors.affiliation: Department of Gastroenterology and Hepatology, Shimane University School of Medicine, Izumo, Japan.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Oka
authors.affiliation: Cancer Center, Shimane University Hospital, Izumo, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Moriyama
authors.affiliation: Department of Gastroenterology and Hepatology, Shimane University School of Medicine, Izumo, Japan; Division of Gastroenterology, Matsue Red Cross Hospital, Matsue, Japan.
authors.forename: Takafumi
authors.initials: T
authors.lastname: Yuki
authors.affiliation: Department of Gastroenterology and Hepatology, Shimane University School of Medicine, Izumo, Japan.
authors.forename: Kousaku
authors.initials: K
authors.lastname: Kawashima
authors.affiliation: Division of Gastrointestinal Endoscopy, Shimane University Hospital, Izumo, Japan.
authors.forename: Shuichi
authors.initials: S
authors.lastname: Sato
authors.affiliation: Department of Gastroenterology and Hepatology, Shimane University School of Medicine, Izumo, Japan.
authors.forename: Shunji
authors.initials: S
authors.lastname: Ishihara
authors.affiliation: Department of Gastroenterology and Hepatology, Shimane University School of Medicine, Izumo, Japan.
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Kinoshita
keywords: Compression; Endoscopy; Fluoroscopy; Rectal foreign body