A Case of Rectal Perforation by a Transanal Foreign Body

Abstract

A 43-year-old man admitted for abdominal pain had suffered abdominal pain developing over four hours. Physical examination showed abdominal distension, whole abdominal tenderness, and muscular rigidity. The White blood count was significantly high and CRP negative. Abdominal CT showed free air and ascites in the upper portion of the abdominal cavity and a low-density mass at Douglas' pouch. Anal bleeding was recognized and a piece of string hung out of the anus. Emergency laparotomy based on a diagnosis of rectal perforation by a transanal foreign body showed serous bloody ascites and a baby bottle in the pelvic cavity that had perforated the anterior rectal wall. We directly closed the rectum with a covering colostomy. When asked how the bottle had become thus situated, he repeated only that it had ponetrated the insertedanus by accident when he slipped in the bath. Six months later, the colostomy was closed.