A foreign body in the rectosigmoid colon often can be removed through the anus. However, it may be necessary to perform a celiotomy to remove some objects that cannot be retrieved by other ways or to manage complications.
Indications for surgery to remove a foreign body:
(1) foreign body lying in the upper portion of the rectum or sigmoid colon
(2) failure in repeated conservative attempts at retrieval
(3) perforation of the bowel wall
(4) sharp edge or point that may damage the bowel wall
Features of a foreign body which may make it difficult to remove:
(1) no edges to grasp
(2) hard
(3) long, rigid and unable to make the turns required to descend into the anal canal
If the bowel wall is intact then an attempt is made to manipulate the object so that it descends to a point where it can be retrieved through the anus. If this fails then a colostomy is performed to remove the object.
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