Published online Apr 16, 2026. doi: 10.12998/wjcc.v14.i11.119572
Revised: February 20, 2026
Accepted: March 10, 2026
Published online: April 16, 2026
Processing time: 68 Days and 20.6 Hours
Rectal foreign bodies (RFBs), mostly due to self-insertion for sexual pleasure, are occasionally encountered in emergency departments. They are more common in young male patients, and because patients often delay seeking medical attention due to embarrassment, complications such as perforation and peritonitis may be present at diagnosis. Emergency physicians must remain mindful of potential RFB insertion and conduct history-taking and physical examinations with sensitivity to patient embarrassment. Reports of penetrating peritonitis caused by long-term RFB retention are rare.
A 16-year-old male experienced persistent fever of approximately 38 °C for 35 days. Although antipyretics and antibiotics were prescribed at a local clinic, his symptoms did not improve. Later, he disclosed that his condition had worsened after inserting a smartphone stand into his rectum 35 days before for sexual gratification, and he was referred to our hospital. Upon arrival, his vital signs were stable, and mild tenderness was noted in the left lower abdomen. Laboratory tests revealed leukocytosis and elevated C-reactive protein levels (5.21 mg/dL). Abdominal computed tomography revealed a spring-like foreign body and a large amount of fecal material in the rectum. Endoscopic removal was unsuccessful; therefore, laparotomy was performed for object extraction. Intraoperatively, the rectum was found to have perforated into the retroperitoneal cavity. The postoperative course was uneventful, and the patient was discharged 11 days after admission.
We report a case of penetrating peritonitis after long-term RFB retention, without an acute abdomen, because the perforation was retroperitoneal.
Core Tip: Rectal foreign bodies (RFBs) are occasionally encountered, and most cases involve self-insertion for sexual pleasure. They are common in young male patients, and because patients often delay seeking medical attention due to embarrassment, complications such as perforation and peritonitis may already be present at diagnosis. Physicians must remain mindful of the possibility of RFB insertion and conduct history-taking and physical examinations with sensitivity to patient embarrassment. We report the first case of penetrating peritonitis caused by long-term RFB retention, which did not present as an acute abdomen because the perforation was confined to the retroperitoneal space.