Patient N.K.N (15 years old, Ha Dong, Hanoi) was admitted to the hospital at night with symptoms of severe pain and tightness in the lower abdomen. X-ray results showed that a large metal foreign object was located deep in the rectum, causing compression of the pelvic organs and posing a risk of serious complications if treated in time.
Faced with the complicated situation, Ha Dong General Hospital activated an emergency consultation process between many specialties including: Emergency Surgery, Diagnostic Imaging, Anesthesia and Resuscitation and Gastrointestinal Surgery to agree on a treatment plan.
After a comprehensive assessment, the surgical team decided to remove the foreign object through the anus to avoid open abdominal surgery, reduce the risk of injury and preserve the patient's function. However, the intervention process faced many challenges when the foreign object was a pestle about 18 cm long, 6 cm in diameter - almost equal to the maximum limit of the anal sphincter in adolescents. The foreign object also created a "vacuum effect" causing it to be drawn tightly into the intestinal lumen.
Throughout the intervention process, the anesthesia and resuscitation team ensures pain control, maximum muscle relaxation and maintains hemodynamic stability, creating favorable conditions for surgeons to operate.
After more than 45 minutes, doctors successfully removed the foreign object through the anus without abdominal surgery.
According to Dr. Bui Thanh Hai - Department of Gastrointestinal Surgery - a member of the surgical team, the biggest difficulty is breaking the vacuum pressure above the foreign object. "If only using simple pulling force, the risk of perineal tear or rectum rupture is very high. We have to coordinate smoothly: one person holds it fixed, another skillfully brings the instrument to bring air to the back of the foreign object to neutralize the suction force," Dr. Hai said.
BSCKII Dinh Hong Kien - Head of Emergency Surgery Department - said that the success of the case is not only thanks to professional experience but also proof of the effectiveness of close coordination between departments in a unified treatment process.
After intervention, the patient was stable, only suffering minor scratches of the rectal mucosa and is being actively monitored. Vital indicators are within normal limits, digestive function is gradually recovering and is expected to be discharged in the next few days.
Doctors warn that inserting foreign objects into the anus can cause many dangerous complications such as intestinal perforation, peritonitis, severe infection or permanent damage to the anal sphincter leading to incontinence.
