Treatment of unusual rectal foreign body using a Foley catheter.

using a Foley catheter A 70-year-oldman presented to our emergency department with a history of abdominal pain and bloating and lack of defecation for 3 days. A round, hard foreign body with a smooth surface was palpated on digital rectal examination. The man admitted having introduced a mandarin into the rectum 4 days previously. An attempt at manual extraction of the foreign body was unsuccessful. Endoscopic examination of the rectum showed that a round, orange-colored mandarin was almost completely obstructing the lumen, and did not allow the colonoscope (Pentax EC-380LKp, Tokyo, Japan) to pass to proximally beyond it (●" Fig.1). Grasping the mandarinwith a 50-mmpolypectomy snare (Endo-Technik, Solingen, Germany) failed because of the mandarin’s round and smooth surface. A 14-French Foley catheter (PlusMed; Sisco Latex PVT, Chennai, India) was inserted and passed proximally to themandarin under colonoscopic observation (●" Fig.2). The balloon of the catheter was inflated with 20mL water and pulled gently. In this way the mandarin was fully extracted without complication (●" Fig.3). After the extraction, control endoscopic examination revealed only mild superficial laceration of the rectal mucosa. The patient was observed for a few hours after the procedure and discharged from the hospital on the same day. Most rectal foreign bodies have been inserted for sexual stimulation and are generally blunt, round, and have a smooth surface. Repetitive insertion of gradually larger objects makes these objects more difficult to remove [1]. Grasping round, large, smooth-surfaced objects is difficult with standard endoscopic devices [2,3]. In such cases, using a Foley catheter in the treatment of rectal foreign bodies may allow a major surgical procedure to be avoided [4].