Anusha Prasad K, Surabhi K, Akhila K, Sharan Javali
Rectal foreign bodies (RFBs) represent an uncommon but challenging surgical emergency. While most cases result from intentional insertion for sexual gratification, accidental insertion is exceedingly rare. Management depends on the size, shape, location, and associated complications of the foreign body. We present a rare case of patient-reported rectal insertion of a health faucet nozzle resulting in rectosigmoid impaction that required laparotomy-assisted transanal extraction. A 40-year-old male presented with anorectal pain, scant bleeding per rectum, mucoid discharge, and lower abdominal pain following an accidental slip-and-fall injury in the bathroom while defecating. Clinical examination revealed a palpable RFB. Plain radiographs demonstrated a foreign body consistent with a plastic health faucet impacted at the rectosigmoid junction. Due to the object's large size, irregular configuration, and proximal location, transanal extraction was considered unsafe. The patient underwent an exploratory laparotomy, during which the foreign body was carefully milked distally to disengage the entrapped rectal mucosa and subsequently extracted transanally without enterotomy or bowel resection. Intraoperative findings included localized rectal wall bruising and mucosal edema without perforation. The patient had an uneventful postoperative course, characterized by the return of bowel function and satisfactory recovery, and was subsequently discharged in stable condition. Accidental rectal insertion of a health faucet is an exceptionally rare cause of rectosigmoid foreign body impaction. This case highlights the importance of careful clinical assessment, appropriate imaging, and individualized operative planning. Laparotomy-assisted transanal extraction can be a safe and effective strategy for the removal of large, impacted rectosigmoid foreign bodies while preserving bowel integrity and avoiding more extensive surgical procedures.