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07-08-2022, 02:00 AM
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Removal of Large Cucumber, Penetrating the Bowel
A large cucumber, penetrating the bowel and needed an urgent laparotomy. The first step in the evaluation and management of a patient with a rectal foreign body is to determine whether or not a perforation occurred. When a perforation is suspected, it should be determined as soon as possible whether the patient is stable or unstable. Hypotension, tachycardia, severe abdominopelvic pain, and fevers are indicative of a perforation. If there is free air or obvious peritonitis indicating a perforation, then the patient needs immediate resuscitation with intravenous fluids and broad-spectrum antibiotics followed by an operation. A Foley catheter and nasogastric tube should be placed, and appropriate blood samples should be sent to the laboratory. If the patient appears stable and has normal vital signs and a perforation is suspected, a computed tomographic (CT) scan often helps determine if there has been a rectal perforation. The majority of cases of rectal foreign bodies are the result of insertion during erotic activity. Typically found objects are vibrators, dildos, light bulbs, candles, shot glasses, and bottles. Some rectal foreign bodies may have been initially swallowed but later present with complications in the rectum. Patients may be very embarrassed to disclose the circumstances regarding the foreign body insertion, and there may have been multiple attempts at self-removal. |