Foreign Body in Rectum (a public service post)

Once again some unfortunate person who lives in Bighospitalburgh has stuck something up their bum and had the misfortune to either through bad luck or excitement, lose their grip on the item (in this case a carrot in a condom) and have it disappear beyond the reach of their frantic fingers.

Once again, this person decided to attempt to retrieve the object and subject themselves to hours of pain, unpleasantness and sphincter stretching damage before accepting that this isn’t something that can be done alone.

Shower heads, carrots, cucumbers, vacuum attachments, bottles, cans, light bulbs, aerosol sprays, handles of brooms…we have seen it all. Inexplicably we have also had a few pens, which seems rather half arsed, if you will pardon the pun.

All of these people have waited a while prior to seeking medical attention and most come to hospital anticipating that we will have some suction device or long tongs that will swiftly and efficiently rid their rectum of the object so they can be once more on their merry way, back home to once again poke about in their posterior.

I haven’t done a retrospective case study on this, but my experience is that these guys are usually married and their wife is unaware of this new interest and it seems to take place when she is away. This was certainly the case last month when my patient turned up via A&E with a carrot in situ. He caused total fucking chaos by using a fake name initially which led to us having massive difficulty in ordering bloods, X-rays and getting notes organised.

By the time we had a real identity and got him assessed and admitted and checked out he was starting to get a bit cross.

I was duty surgeon and had the job of explaining that his retrieval foreign body rectum and examination under anaesthetic was scheduled for the end of the emergency list, which would likely happen at around 2am. Mr Carrot was displeased, he wanted it all dealt with somewhat faster, he felt that as he had accidentally fallen on top of the carrot and had the almost unbelievable misfortune for it to go right up his ass he should be dealt with a bit quicker. The reasons for this urgency, in his estimation, being; the carrot could be causing damage and his wife was due home soon and he didn’t feel the need to worry her about this.

Wives quite often don’t know what their husbands get up to, that’s why deleting browsing histories was invented, and Mrs Carrot was no exception. I reassured him that we would give no information over the phone or to her in person about his admission and that our discretion and confidentiality could be relied on. I suggested that a peri-anal abscess would be a suitable cover story (I know, loads of lies for and to patients recently). He duly phoned his wife and told her he had an abscess and was going to theatre that night.

Of course, Bighospital is a big hospital and at midnight we had an emergency operation to do that took my patient’s slot in emergency theatre. By the time the laparotomy was finished it was 5am so a decision was made to put Mr Carrot off until the morning, which he was very cross about and let me know about when I saw him at 8am.

I took him to theatre a short while later and removed a really quite thick looking carrot from his rectum, which I disposed of, confident that he would not want it back. He then did what almost everyone does in that situation, he absconded from the ward very soon after he was returned from theatre never to be seen or thought of again.

However, this man was so intent to keep up the story about his admission to his wife that he has now had the audacity/madness/balls to write a complaint about his admission and brief stay for his “abscess” due to the delay in getting his procedure. I have had to respond to this, mindful that I don’t breach confidentiality of either his carrot cover story or the life or death laparotomy that took precedence over him in the middle of the night.

So, in an attempt to improve our service to people with this embarrassing and frightening problem here is my guide to what to do in this situation:

1. Don’t keep trying, you won’t get it out.
2. Don’t eat or drink anything from now on, you need to fast as you are going to theatre.
3. A good cover story is that you have peri-anal sepsis. The length of stay and the embarrassment factor that your wife will pick up on can be explained by an infected peri-anal haematoma or skin tag. The operation is also the same “examination under anaesthetic”.
4. We won’t give you a fake or inaccurate discharge letter. You are on your own there to dispose of or alter that accordingly.

We don’t care what you’ve stuck up there, we have seen it all before. We won’t tell anyone in your family, we can’t tell them unless you say. We are a little bit amused, but we won’t seem so to your face and we will protect your dignity and confidentiality. Lots of people do this and we will ask you how it happened and examine you carefully but that is because it is our job to do so.

Don’t delay seeking medical attention; abdominal pain, nausea and vomiting, pain on coughing or laughing necessitate urgent medical attention. It usually just goes in to the top of the rectum but some things can perforate the bowel and cause peritonitis. I have never seen this, even with lightbulbs so don’t be alarmed.

Mr Carrot has had the briefest and blandest of complaint responses from me where I once again have not breached his confidentiality.

He owes me a drink if he ever sees me again.

In general, prevention is better than cure so if you are stumbling across this post whilst contemplating some “back door fun” with something not designed for the purpose (google with flange) my advice is don’t do it.

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Preferably organic

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7 thoughts on “Foreign Body in Rectum (a public service post)

  1. excellent “carrot” post written in the most “corny” way!
    ( fyi: was reading on carrot cake recipe
    my boy’s birthday before I realised I havent log on to ur blog for a while! yummaeyyy..)

    anyway KBW , may i know how u hv written the complaint response,
    ( I hate answering those) and there wasnt like a lesson to take from teachers or book and not like they’ve thought us in medical
    school..and our bosses expects us to “deal” it with tact ( my a*s)

    would love to see a post of that.. ? pretty pls
    ( maybe with lots of names/terms striked off )
    Yee ling
    msia

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