Rectal foreign body of a cosmetic bottle treated successfully by transanal retrieval: A case report

Rationale:Retained rectal foreign bodies (RFBs) are unusual clinical presentations whose management is challenging for emergency physicians owing to variations in the object types, anorectal anatomy, sacral curvature, insertion times, and local contamination. Here, we present the diagnosis and treatment in 1 case of retained rectal foreign body.Patient concerns:A 62-year-old male presented to the emergency department with a cosmetic bottle inserted into the rectum while bathing. He had difficulty defecating and denied any underlying psychiatric illness. Before coming to the hospital, the patient attempted to remove the cosmetic bottle with a screwdriver but failed, causing the cosmetic bottle to penetrate further into the intestinal lumen. The patient felt that the anal bulging was gradually worsening.Diagnoses:Investigations, a digital rectal examination, and coronal abdominal computed tomography revealed a foreign body stuck in the rectum.Interventions and outcomes:After lateral internal sphincterotomy, the cosmetic bottle's plastic cap was pinched using a towel clamp and rotated slowly. The patient had an uneventful recovery period; the difficult defecation and anal bulging were relieved.Lessons:This case proves that lateral internal sphincterotomy can be performed to remove retained rectal foreign bodies if sufficient sphincter relaxation and anal dilatation cannot be achieved with proper anesthesia.