Abstract

Rectal Foreign Body in South Asia: A Systematic Review

Shivam Pandey1, Susmita Khadka Chhetri1, Aayucee Agrawal1, Chahana Pathak2, Sushant Thapa1, Meraj Kamal3, Bolbam Rajak4, Arati Bartaula5, Sasi Bhushan Kushwaha6, Parbatraj Regmi7

Keywords: Rectal foreign body, South Asia, polyembolokoilamania, transanal, sexual gratification

DOI: 10.63475/yjm.v5i1.0344

DOI URL: https://doi.org/10.63475/yjm.v5i1.0344

Publish Date: 22-04-2026

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Author Affiliation:

1 Medical Officer, Ministry of Health and Population, Kathmandu, Nepal
2 MBBS Student, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
3 Medical Officer, Department of Radiodiagnosis and Interventional Radiology, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
4 Medical Officer, Madan Bhandari Hospital and Trauma Center, Mangalbare, Nepal
5 Medical Officer, Nepal National Hospital, Kathmandu, Nepal
6 Intern Doctor, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
7 Senior Resident, Department of Surgery, B.P. Koirala Institute of Health Sciences, Dharan, Nepal

Abstract

This systematic review aims to analyze patient demographics, insertion routes, intent, types of foreign bodies, clinical presentations, complications, and outcomes of rectal foreign bodies (RFBs) in South Asia, and to propose a management algorithm. A systematic review of case reports and case series was conducted following PRISMA 2020 (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Inclusion criteria included case reports/series of RFBs from South Asian countries with the foreign body in situ or displaced to an adjacent organ. Exclusion criteria comprised non-English articles and unavailable full texts. PubMed and Google Scholar were searched on March 5, 2023, without date restrictions. Risk of bias was assessed using the JBI Critical Appraisal Checklist for Case Reports. Data were synthesized narratively, with descriptive statistics (means, SD, and frequencies) and chi-square tests for associations, using MS Excel and JASP 0.17.3.0. The review included 108 cases from 59 case reports/series, predominantly males (95 males, 11 females, 2 unspecified), with a mean age of 33.95 years (±15.09 SD). Transanal insertion (87 cases) was the most common route, followed by ingested (14 cases) and iatrogenic (7 cases) RFBs. Management involves imaging (X-rays/computed tomography), manual or endoscopic retrieval, and surgical intervention for complications like perforation (9.2%) or peritonitis (16.9%). Post-extraction sigmoidoscopy and psychological evaluation are crucial. The diversity of the foreign objects and variability in presentations require a high index of suspicion and a sensitive and structured clinical approach.