In 1986, surgeons Busch and Starling collected all the evidence disseminated by medical journals about foreign bodies lodged in people's buttocks. In the 182 cases collected, they found that the most recurrent objects were bottles (32) and sexual devices such as vibrators and dildos (38).
Things started to get interesting when blunt knives, ice picks, jeweller’s saws, screwdrivers, balls and all kinds of vegetables with the right shape appeared. The cited article also refers to vaginal foreign bodies and injuries of the large intestine due to practices such as fisting (which can be dangerous if not performed carefully), colorectal instrumentation, pneumatic rupture, ingestion of foreign bodies, impalement and abdominal trauma.
Of course, some of these lurid situations have their grace, like the one reported by Vaman S. Diwan in November 1982 in the Annals of Emergency Medicine (the name of the journal already has its grace... annals). A 54-year-old man came to the emergency room because, he told the doctors, he had been drinking bourbon two days earlier and "did something" to his rectum. After the X-ray everything was clear and bright: he had a 100 W bulb stuck up his ass. The good man finally had to confess that while he was drunk with his colleagues he had bet a hundred dollars that he could get a light bulb up his ass. Just like that? No, he used shaving foam as a lubricant. The article describes the careful technique that had to be followed to remove such a fragile object without destroying the rectum.
The cherry on top comes when a cement enema is found in the rectum of a person. Doctors Peter J. Stephens and Mark L. Taff describe the particular scenario where a heterosexual couple was ‘playing around’ and one of them introduced a mixture of cement into his partner’s anus. It took them more than 4 hours to go to the emergency room and so the cement ended up being stuck in his anus.
The vast majority of cases are males
More recently, in 2014, a meta-analysis was published, that compiled the conclusions of reports published between 1980 and 2012 with the data available using the PubMed website and the keywords "rectal foreign body".
A total of 589 cases were found, consisting of 556 male and 33 female patients with an average age of 41 years.
Interestingly, 94.4% of the patients were male. A wide variety of objects were observed in the reports, including bottles, vibrators, fruits, vegetables, tools and miscellaneous items such as light bulbs, candles, balls and flashlights.
Regarding treatment: the management of these cases varied from simple manual recovery, with or without general anaesthesia, or the use of a sigmoidoscope. Eighty patients (13.6%) required surgery, although manual recovery was possible in the remaining patients. Among the patients who underwent surgery, stomas (surgically created artificial opening between a hollow viscera and the body surface) were created in 53 patients (66.2%).
On the other hand, the laparoscopic approach to assist in the rectal removal of foreign bodies is a good treatment option for difficult cases, since it allows easy removal and detection of rectal lesions.