Rectal foreign bodies are a common presentation in emergency departments, predominantly
observed in males and often associated with masturbation or sexual practices [1]
[2]. Endoscopic removal using a snare is the most common approach, but this method often
fails for larger, smoother objects [3]
[4]. In this report, we report a case of successful removal of a rectal foreign body
using a self-made snare, which was created by folding a 0.035-inch, 460-cm guidewire
into a loop ([Video 1]).
Endoscopic removal of a large rectal foreign body using an ERCP guidewire snare.Video
1
A 68-year-old man presented to the emergency department 8 hours after unsuccessful
attempts to remove a foreign body he had inserted into his rectum. Abdominal CT and
3D reconstruction revealed a large foreign body lodged in the left colon, approximately
20 cm in length with an enlarged tail segment ([Fig. 1]). Emergency colonoscopy confirmed its presence 15 cm from the anus.
Fig. 1 The CT imaging of foreign body. Abdominal CT and 3D reconstruction revealed a large
foreign body lodged in the left colon, approximately 20 cm in length with an enlarged
tail segment.
Initial attempts to remove the object using foreign body forceps and a snare were
unsuccessful due to the object’s smooth surface and the significant resistance it
presented. Similarly, a standard 40-mm polypectomy snare failed to grasp the distal
end of the object because of its size. To address this, we designed a novel snare
device using an endoscopic retrograde cholangiopancreatography (ERCP) guidewire ([Fig. 2]). A 0.035-inch, 460-cm guidewire was folded, and both ends were inserted retrogradely
through the endoscopic accessory channel. This design allowed for adjustable snare
diameter based on the foreign body’s size.
Fig. 2 The self-made snare. A 0.035-inch, 460-cm ERCP guidewire was folded, and both ends
were inserted retrogradely through the endoscopic accessory channel to form a snare.
Abbreviation: ERCP, endoscopic retrograde cholangiopancreatography.
Using this self-designed device, we carefully secured the distal edge of the object
and successfully extracted it. The foreign body was identified as a silicone penile
prosthesis measuring approximately 200 mm in length and 50 mm in diameter ([Fig. 3]).
Fig. 3 The foreign body. The foreign body was identified as a silicone penile prosthesis
measuring approximately 20 cm in length and 5 cm in diameter.
Endoscopy_UCTN_Code_TTT_1AQ_2AH
E-Videos is an open access online section of the journal Endoscopy, reporting on interesting cases and new techniques in gastroenterological endoscopy.
All papers include a high-quality video and are published with a Creative Commons
CC-BY license. Endoscopy E-Videos qualify for HINARI discounts and waivers and eligibility is automatically checked during the submission
process. We grant 100% waivers to articles whose corresponding authors are based in
Group A countries and 50% waivers to those who are based in Group B countries as classified
by Research4Life (see: https://www.research4life.org/access/eligibility/).
This section has its own submission website at https://mc.manuscriptcentral.com/e-videos.
