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Rectal foreign body
Guidelines
Key sources
The following summarized guidelines for the evaluation and management of rectal foreign body are prepared by our editorial team based on guidelines from the World Society of Emergency Surgery (WSES/AAST 2021).
1
Diagnostic investigations
Clinical examination
As per AAST/WSES 2021 guidelines:
Consider eliciting a focused medical history and performing a complete physical examination in patients with suspected retained anorectal foreign body.
C
Consider performing DRE after the acquisition of an abdominal X-ray, whenever possible, in patients with suspected retained anorectal foreign body to prevent accidental injury to the surgeon from sharp objects.
C
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Diagnostic imaging
Laboratory tests
Diagnostic procedures
Medical management
Antibiotics
As per AAST/WSES 2021 guidelines:
Avoid using routine antimicrobials in patients with retained anorectal foreign body.
D
Administer broad-spectrum antibiotics according to the WSES guidelines on intra-abdominal infections in patients with retained anorectal foreign body and signs of hemodynamic instability or perforation.
B
Therapeutic procedures
Bedside transanal extraction: as per AAST/WSES 2021 guidelines, consider performing bedside extraction as first-line therapy in patients with low-lying retained anorectal foreign body without signs of perforation.
C
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Endoscopic extraction
Laparoscopic extraction
Surgical interventions
Surgical extraction, indications: as per AAST/WSES 2021 guidelines, consider performing surgery in patients with retained anorectal foreign body and without signs of perforation, if transanal extraction was failed.
C
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Surgical extraction (closure)