Rectal foreign body removal: increasing incidence and cost to the NHS

• Published in: Annals of the Royal College of Surgeons of England Vol. 103; no. 10; pp. 734 - 737
• Main Authors: Bhasin, S, Williams, J G
• Format: Journal Article
• Language: English
• Published: England BMJ Publishing Group LTD 01-11-2021; Royal College of Surgeons
• Subjects: Adolescent; Adult; Adults; Age Factors; Age groups; Aged; Aged, 80 and over; Anus; Child; Child, Preschool; Colorectal Surgery; Conspiracy; Eroticism; Female; Foreign bodies; Foreign Bodies - economics; Foreign Bodies - epidemiology; Foreign Bodies - surgery; Foreign-Body Migration - economics; Foreign-Body Migration - epidemiology; Foreign-Body Migration - surgery; Gender; General anesthesia; Health Care Costs - statistics & numerical data; Hospitals; Humans; Infant; Laparotomy; Length of Stay - economics; Length of Stay - statistics & numerical data; Male; Middle Aged; Ostomy; Patients; Rectum; Rectum - surgery; Sex Factors; State Medicine - economics; State Medicine - statistics & numerical data; Trauma; United Kingdom - epidemiology; Young Adult; United Kingdom; United Kingdom > UK; England; Foreign body; Coloproctology; Rectum; Incidence
• ISSN: 0035-8843; 1478-7083
• DOI: 10.1308/rcsann.2020.7129

Insertion of foreign objects into the rectum is a well-described phenomenon and not an uncommon referral to the general surgeon on call. Although usually not life-threatening, there can be consequences following migration of the object or perforation of the large bowel. This study looks at the incidence of removal of foreign objects from the rectum over the last decade and the financial burden it presents to the NHS.
Hospital Episode Statistics for 2010-2019 were used to calculate the number of rectal foreign bodies that required removal in hospital. Data for age groups and genders have been compared.
A total of 3,500 rectal foreign bodies were removed over the course of 9 years. Males accounted for 85.1% of rectal foreign bodies whilst 14.9% were females. This equates to 348 bed-days per annum. Admission peaks were observed in the second and fifth decades of life.
This study shows that the incidence of rectal foreign bodies is higher in men and has been increasing over the period studied. Most foreign bodies can be removed trans-anally with the use of anaesthesia, with only a small proportion of patients requiring hospital stay over 24 hours (mean length of stay = 24 hours). Nearly 400 rectal foreign body removals are performed each year with an annual cost of £338,819, illustrating the effect this has on NHS resources.