2021 Volume 41 Issue 7 Pages 599-602
Foreign bodies in the intestinal tract could be introduced via trans-anal insertion for the purpose of masturbation, etc., rarely reaching the adoral rectum below the peritoneal reflection in such cases. In this study, we report a case in which an anally inserted foreign body lodged in the sigmoid rectum was extracted by hand-assisted laparoscopic surgery（HALS）. The patient was a 67-year-old man with a 2-to 3-year history of repeatedly inserting and ejecting foreign objects, such as balls, into and from his anus for the purpose of masturbation. He visited our emergency room complaining of difficulty in ejecting a foreign body that he had inserted 2 days previously and persistent abdominal pain since. Examination revealed that the foreign object was located in the sigmoid colon. We attempted to remove it by lower gastrointestinal endoscopy under general anesthesia with complete endoscopy, but it was difficult to move or grasp. Finally, the foreign object was removed successfully by colonoscopy with HALS. Based on the experience reported from Japan, we created a treatment algorithm for foreign body removal from the intestinal tract with a minimal risk of peritonitis/gastrointestinal perforation.
