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A middle-aged male presented with lower abdominal pain and obstipation lasting two days; digital rectal examination showed a collapsed rectum without a palpable mass, while imaging and colonoscopy identified a radiolucent cylindrical plastic object at the rectosigmoid junction. Exploratory laparotomy with sigmoid enterotomy enabled removal of a 20 cm broom-stick handle, followed by sigmoid loop colostomy, with uncomplicated recovery and later closure.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/sas-journal-of-surgery-an-interesting-surgical-case-of-unyielding-intruder-of-rectum/136515/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/sas-journal-of-surgery-an-interesting-surgical-case-of-unyielding-intruder-of-rectum/136515.png","ImageObject",300,407,{"name":92,"@type":93},"Bill Black","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-09-22","2026-08-22",true,{"@type":102,"interactionType":103,"userInteractionCount":29},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What is the main surgical challenge of impacted rectal foreign bodies?","Question",{"text":112,"@type":113},"They are rare but difficult emergencies because they can lead to impaction, obstruction, and potential perforation, often requiring careful localization and tailored intervention.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How was the foreign body diagnosed in this case?",{"text":117,"@type":113},"Digital rectal examination showed a collapsed rectum without a palpable mass, and imaging plus colonoscopy confirmed a radiolucent cylindrical foreign body at the rectosigmoid junction with mucosal erosions and ulcers.",{"name":119,"@type":110,"acceptedAnswer":120},"Why was laparotomy chosen instead of transanal or endoscopic removal?",{"text":121,"@type":113},"Surgery was required due to the large, proximally impacted object and the need for definitive management when non-operative/endoscopic extraction is unlikely or fails, especially with associated mucosal injury.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},136515,1787388054,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":29,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":81,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":129,"read_time":39},24189269381491,"https://ap-avatar.wpscdn.com/avatar/160000cf11732dd8392?x-image-process=image/resize,m_fixed,w_180,h_180&k=1788146458752108895","SAS Journal of Surgery  \nAbbreviated Key Title: SAS J Surg ISSN 2454-5104  \nJournal homepage: [https://www.saspublishers.com](https://www.saspublishers.com)  \n| An Interesting Surgical Case of Unyielding Intruder of Rectum\u003Cbr>Dr. Gandeti. Kiran Kumar, M. S. 1*, Dr. Aithagani. Aruna, M. S.2, Dr. Nuukala. Geethika3, Dr. Kale. Prem Samuel4, Dr. Nammi Bhagya Sree5 |  |  |\n| --- | --- | --- |\n| 1Professor, Department of General Surgery, Guntur Medical College, Guntur, Andhra Pradesh, India 2,3,4,5Department of General Surgery, Guntur Medical College, Guntur, Andhra Pradesh, India |  |  |\n| DOI: [https://doi.org/10.36347/sasjs.2026.v12i01.010](https://doi.org/10.36347/sasjs.2026.v12i01.010 | Received:)[ |](https://doi.org/10.36347/sasjs.2026.v12i01.010 | Received:)[ Received:](https://doi.org/10.36347/sasjs.2026.v12i01.010 | Received:) 04.11.2025 | Accepted: 12.01.2026 | Published: 14.01.2026\u003Cbr>*Corresponding author: Dr. Gandeti. Kiran Kumar, M.S.\u003Cbr>Professor, Department of General Surgery, Guntur Medical College, Guntur, Andhra Pradesh, India |  |  |\n| Abstract |  | Case Report |\n\nBackground: Rectal foreign bodies represent a rare but challenging surgical emergency, often due to voluntary insertion for various reasons, leading to impaction, obstruction, and potential perforation. Management ranges from transanal retrieval to laparotomy for proximal objects. Case Presentation: A middle-aged male presented with lower abdominal pain and obstipation for 2 days. Digital rectal examination revealed a collapsed rectum without palpable mass. Imaging confirmed a radiolucent cylindrical foreign body (? plastic) in the lower rectum, with colonoscopy showing mucosal erosions, ulcers, and the object at the rectosigmoid junction. Exploratory laparotomy with sigmoid enterotomy facilitated removal of a 20 cm long broom stick handle, followed by sigmoid loop colostomy. Postoperative recovery was uneventful, with colostomy closure after 6 months. Conclusion: High impacted rectal foreign bodies necessitate tailored surgical intervention. Psychiatric evaluation is essential to prevent recurrence.  \nKeywords: Rectal foreign body, rectosigmoid impaction, laparotomy, sigmoid enterotomy, colorectal emergency, abnormal sexual behaviour.  \nCopyright © 2026 The Author(s): This is an open-access article distributed under the terms of the Creative Commons Attribution 4.0 International License (CC BY-NC 4.0) which permits unrestricted use, distribution, and reproduction in any medium for non-commercial use provided the original author and source are credited.  \nINTRODUCTION  \nRectal foreign bodies occur due to assault, accidental trauma, concealment, or sexual stimulation, with incidence underreported owing to social stigma and embarrassment. Mean age of presentation being 53.8 ± 15.5 years (range, 1 ~ 88 years) among which (77.3%) were male and (22.7%) were female [6] . Risk factors include abnormal sexual behaviour and psychosocial disorders. Complications encompass mucosal tears, obstruction, perforation, and sphincter injury. Initial management involves anal dilatation under anaesthesia; colonoscopy; laparotomy is reserved for proximalimpactions. This report details a rare case requiring surgical intervention for a large impacted object.  \nImpaction of foreign bodies in the rectosigmoid junction is an uncommon but important surgical emergency that poses significant diagnostic and therapeutic challenges. The rectosigmoid junction is a frequent site of impaction because of its sharp angulation, reduced luminal diameter, and relative fixation, which hinder spontaneous passage and transanal retrieval. Plastic foreign bodies are particularly difficult to manage as they are, often non-radiopaque, and resistant to grasping with conventional instruments,  \nincreasing the likelihood of failed non-operative removal attempts [1] .  \nPatients often present late due to embarrassment or social stigma, leading to delayed diagnosis and higher risk of complications. Clini","cbCaii36cDX8c6LV","https://ap.wps.com/l/cbCaii36cDX8c6LV","pdf",376208,"English","# Abstract\n# Background and Introduction\n## Causes and Risk Factors\n## Diagnostic Approach\n## Management Options\n# Case Presentation\n## Clinical Findings and Timeline\n# Conclusion","[{\"question\":\"What is the main surgical challenge of impacted rectal foreign bodies?\",\"answer\":\"They are rare but difficult emergencies because they can lead to impaction, obstruction, and potential perforation, often requiring careful localization and tailored intervention.\"},{\"question\":\"How was the foreign body diagnosed in this case?\",\"answer\":\"Digital rectal examination showed a collapsed rectum without a palpable mass, and imaging plus colonoscopy confirmed a radiolucent cylindrical foreign body at the rectosigmoid junction with mucosal erosions and ulcers.\"},{\"question\":\"Why was laparotomy chosen instead of transanal or endoscopic removal?\",\"answer\":\"Surgery was required due to the large, proximally impacted object and the need for definitive management when non-operative/endoscopic extraction is unlikely or fails, especially with associated mucosal injury.\"}]","SAS Journal of Surgery - An Interesting Surgical Case of Unyielding Intruder of Rectum | PDF"]