An unusual delivery

From: The British Journal of Hospital Medicine , 51(11), pg.615, 1994
Submitted by: Fred Oliver, University of CT

In an attempt to ease his constipation, a 64-year-old man had inserted a microwave egg boiler (MEB) into his rectum. This is an egg-shaped device -- 11 cm in diameter at its widest point -- with a rim at the base, and in two halves that can be joined firmly together. Unfortunately, the MEB rather exacerbated his constipation and he presented to us several hours later.
Digital manipulation, bed rest and analgesia failed to relieve the problem and so he was listed for extraction of the MEB under general anaesthesia. He was placed in the lithotomy position and attmpts at manual extraciton were made. When these failed, two spong forceps and then two Blacks tissue forceps were attached to the rim at the MEB base; traction was applied combined with periabdominal pressure from the anaesthetist. This succeeded only in rotating the MEB about its longitudinal axis, partly as a result of its widest diameter being wedged above the ischial spines and partly because the base was impacting on the rectal valves.
After a period of quiet contemplation, a pair of Wrigley's obstetric forceps were ordered from the labour ward. These were inserted around the egg as around the head of a baby, traction was applied along the pelvic curve and the MEB was 'delivered' with aplomb. Our patient suffered no further problems and indeed opened his bowels before discharge, his constipation cured.
This is not the first use of obstetric forceps to remove rectal foreign bodies (MacDonald, 1961; Burre, 1969; Peet, 1976; Busch and Starling, 1986), but it illustrates the need for versatility among surgeons in the face of an ever-increasing array of modern-day obstacles.

PJ Whatling
Surgical Senior House Officer
Department of Surgery
MRW Stacey
MSC Lecturer
Department of Anaesthetics
University Hospital of Wales
Cardiff CF4 7EQ

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