rectal foreign body
Introduction
Introduction to foreign bodies in the rectum Ingested foreign bodies include catheters, chicken bones and fishbone; gallstones or fecal stones can stay at the anorectal junction; urinary stones, vaginal rings or surgical sponges or instruments may erode into the rectum; some are odd or related to sexual performance The foreign body is artificially inserted and unintentionally incarcerated; some substances are embedded in the rectal wall, and some foreign bodies are embedded in the anal sphincter, etc., and these foreign substances enter and corresponding symptoms are called foreign bodies in the rectum. basic knowledge The proportion of illness: 0.005%-0.007% Susceptible people: no specific population Mode of infection: non-infectious Complications: peritonitis toxic shock syndrome
Cause
Cause of foreign body in rectum
Ingestion of foreign bodies (50%):
Ingestion or accidental ingestion of foreign objects that can be incarcerated. There are many kinds of foreign objects swallowed, and the most common ones are pins, needles, hairpins, coins, buttons, round nails, screws, small toys, dentures, etc. Generally speaking, any foreign body that can pass through the esophagus or the cardia can pass through the entire gastrointestinal tract. However, according to statistics, about 5% of foreign bodies will be embedded in a certain part of the gastrointestinal tract, especially at the pylorus, duodenum and ileum.
Gallstones (20%):
Gallstone or fecal stone in the rectum. The foreign body usually stops in the middle of the rectum, where the foreign body cannot pass the angle of the rectum. Foreign objects can be touched during anal finger examination.
Iatrogenic foreign body (10%):
The iatrogenic foreign body remains in the intestines.
Prevention
Rectal foreign body prevention
Avoid eating inadvertently; actively treat internal organs and stones. Pay attention to rest, light diet, and drink plenty of water.
Complication
Rectal foreign body complications Complications peritonitis toxic shock syndrome
1. Perforation in the rectal rectum.
2. Peritonitis.
3. Toxic shock.
Symptom
Symptoms of foreign body in the rectum Common symptoms Rectal pain Rectal pain in the anus and discomfort
Sudden cracking pain during defecation should be suspected of penetrating foreign bodies, which just stay at or above the anorectal junction. Other symptoms depend on the size and shape of the foreign body, the residence time in situ, and the presence or absence of infection or perforation. .
The foreign body usually stops in the middle of the rectum. The foreign body can not pass the angle of the rectum flexion. The anal finger can touch the foreign body during the examination. It may be necessary to perform abdominal and chest X-ray examination to exclude the perforation of the rectum.
Examine
Examination of foreign bodies in the rectum
The foreign body usually stops in the middle of the rectum, where the foreign body cannot pass the angle of the rectum. Foreign objects can be touched during anal finger examination. It may be necessary to perform an abdominal and chest X-ray to exclude perforation in the rectal rectum.
1. X-ray abdominal plain film. Abdominal plain film is a photograph of the abdomen taken without introducing any contrast. When a certain organ is calcified due to disease or has X-ray foreign bodies, stones, or free gas in the abdominal cavity, the gas and liquid in the intestinal cavity increase. When the intestines are dilated, the difference in density will appear and appear on the photo. Pure metal foreign bodies can be confirmed by X-ray examination.
2. Barium meal angiography. Non-metallic foreign bodies are helpful through swallowing angiography. If there is bleeding or perforation, it is forbidden to check the barium meal.
Diagnosis
Diagnosis and identification of foreign bodies in the rectum
diagnosis
Diagnosis can be based on medical history, clinical symptoms, and laboratory tests.
Differential diagnosis
Identification with intestinal malignancies.
In the process of anorectal diagnosis and treatment, it is more common to find a rectal extramucosal mass by fingering. Because the extramucosal mass is not as intuitive as rectal cancer, it is difficult to identify both benign and malignant, so it is often misdiagnosed. The rectal extramucosal mass has a complex origin and can be derived from the extramucosal wall tissue or extraintestinal tissue. According to the nature of the lesions, these masses can be divided into three categories: 1 benign tumors, such as leiomyoma, fibroids, etc.; 2 malignant tumors (including primary and metastatic), such as leiomyosarcoma, malignant lymphoma, teratoma, gastric cancer planting metastasis Etc; 3 inflammatory mass or other benign hyperplasia, such as tissue-responsive hyperplasia or mechanization after acne injection treatment, tuberculous granuloma.
There are fewer common symptoms of rectal extramucosal mass, most of which are found in rectal perineal symptoms. These symptoms are very similar to rectal cancer, so if the results are simply confused with rectal cancer, especially The tumor breaks through the rectal mucosa. A comprehensive inquiry of the medical history will help the diagnosis. The intracavitary B-ultrasound can determine the size and extent of the tumor, and it is also helpful to determine the source of the tumor. For larger tumors or tumors from the tibia, CT or MRI can understand the tumor's occupancy and damage. Some tumors are derived from the metastasis of gastrointestinal tumors, and attention should be paid to finding primary lesions, such as gastroscopes and barium meal. Tumor biopsy is the only means of diagnosis. Biopsy should be performed under good anesthesia, the anal sphincter is relaxed, the mucosa is cut open, and the mass is cut under clear vision. Repeated biopsy can be repeated multiple times, and most cases can be diagnosed.
