How do they remove things in the emergency room?
Embarrassing question: let’s say I got something stuck up my bum. And let’s say it isn’t an officially approved anal sex toy. I’ve been told before that you’re supposed to go an emergency department, but what happens once you’re there? I’m afraid to ask how they get these things out?
The first thing to know about those now unwanted objects up your or anyone else’s bum is that they’re a common sight in ER departments and something doctors and nurses expect. A night without a misplaced toothbrush or potato is, apparently, not much of a night.
In “Emergency Department Management of Retained Rectal Foreign Bodies”, a paper that lays out some basic standards of practice for the removal of rectal foreign bodies (the medical and slightly sci-fi term for the situation at hand), Dr. Richard Wigle suggests that doctors should keep this possibility in the front of their minds when people present with otherwise unexplainable anal pain.
Knowing how common this is might make people more likely to seek help right away, so let’s consider some anal ER stats:
- 78% of the cases in ER rooms of rectal foreign bodies are the result of sexual activity.
- More men than women present with unexplained anal pain that is revealed to be an object stuck in their rectum or colon.
- Only one third of people admit the reason for their arrival at the ER.
- Common excuses for the pain is an accident (“I fell on something”) or some sort of therapeutic technique gone wrong.
The longer you take to tell the ER people what’s wrong, the longer it will take for them to help you, so the easiest and best thing you can do is tell the ER people exactly what’s in there, how long it’s been in there, and whether there is anything else that went in before or after it.
Once you’ve spilled the beans (metaphorically speaking), you’ll be assessed to determine whether or not yours is an emergency that needs to be attended to immediately. Depending on how much pain you are in, if you have a fever, and what exactly is stuck up there, you may have to wait or you might be seen right away.
When you’re finally behind the flimsy paper curtain the first step is to determine where the object is in your body. This can be done either by feeling around (both outside and inside your body) or by X-ray if the doctor isn’t able to “visualize” the object.
How they will try to remove the object depends on a number of things, including how far up the object is, what the object is, and any other factors that are relevant at the time (possibly including your body, your health, etc…).
The first course of action is usually to try and remove the object anally either with instruments or the physician’s fingers. Often they will give you a local anesthesia to help dilate the rectum and relax the sphincter muscles.
If this is not possible, removal may require surgery under general anesthetic.
Most recently, there was an incident written up involving a stuck toothbrush case. The doctors were unable to feel the object either through the anus or by external exam. They used laparoscopic assistance to both locate the object and to actually push down on the object while simultaneously pulling it out through the anus.
In most cases these stories end well (although granted, not as well as the individual might originally have hoped for). The major concern is whether there is any tearing in the rectum or colon. This can happen either when an object went in, or as it’s being removed, and if tearing is observed it is considered a surgical emergency.
As an end note, let me quote from the final paragraph of the riveting 2005 paper “Laparoscopic-Assisted Rectal Foreign Body Removal: Report of a Case” where doctors Berghoff and Franklin, who were the first to report on the laparoscopic technique prove that medical journal writing need not be without personality:
“To our knowledge, no such case has been reported and this approach should be considered the next time the frequently amusing, but often difficult, rectal foreign body presents itself.”
Sources:
- Berghoff, K.R. & Franklin, M.E. “Laparoscopic-Assisted Rectal Foreign Body Removal: Report of a Case.” Diseases of the Colon & Rectum Vol. 48, Issue 10 (October 2005): 1975-1977.
- Wigle, R.L. “Emergency Department Management of Retained Rectal Foreign Bodies.” American Journal of Emergency Medicine Vol. 6, Iss. 4 (July 1988): 385-389
