Migration of a foreign body to the rectum A case report and literature review

Rationale: Rectal foreign bodies are not an uncommon finding in outpatient departments globally. Most such objects are inserted through the anus. Occasionally, a foreign body may be ingested and may successfully pass through the entire gastrointestinal tract and be held up in the rectum. In extremely rare cases, foreign bodies in adjacent tissues or organs can penetrate the rectal wall and enter the rectal lumen. We report a rare case that the IUCD had migrated and was embedded in the rectal wall. A part of the IUCD was loosened and deformed into a metallic wire that protruded through the anus. Patient concerns: A 45-year-old woman presented with complaints of a metallic wire protruding through her anus when she used the washroom. The wire would become longer when she manually pulled it; however, this process was associated with pain in the lower abdomen, and she therefore stopped manipulating it. Diagnoses: A rectal foreign body secondary to intrauterine contraceptive device (IUCD) migration and rectal perforation, as well as a pelvic cyst. Interventions: Under general anesthesia, she underwent laparoscopic removal of the rectal foreign body, pelvic adhesiolysis, pelvic cyst resection, and ileostomy combined with colonoscopy. Outcomes: Her postoperative recovery was uneventful. Lessons: Foreign bodies in adjacent tissues or organs can penetrate the rectal wall and enter the rectal lumen. Regular follow-up after IUCD insertion is very important. We report this rare case that would increase awareness among clinicians regarding the differential diagnosis and treatment in such cases.