The following is a summary of “Epidemiology and healthcare utilization for rectal foreign bodies in United States adults, 2012–2021,” published in the July 2023 issue of Emergency Medicine by Loria et al.

Rectal foreign bodies are a prevalent reason for visits to the emergency department, but little epidemiologic information is available on this condition. This hinders the ability to provide trainees with evidence-based education regarding the populations affected, categories and frequency of foreign bodies, and hospitalization factors. Researchers analyzed national estimates of emergency department visits for rectal foreign bodies in the United States to address this issue from 2012 to 2021. They queried the National Electronic Injury Surveillance System for any ‘pubic region’ or ‘lower trunk’ injuries with a foreign body, puncture, or laceration diagnosis. To identify cases of rectal foreign bodies, two authors manually reviewed all clinical narratives. 

National estimates were determined using weighting and strata variables; incidence rates were calculated using census data, trends were evaluated using linear regression, and hospitalization risk factors were identified using multivariable logistic regression. From 2012 to 2021, there were an estimated 38,948 (95% CI, 32,040-45,856) emergency department visits for rectal foreign bodies among individuals ≥15 years old, based on 885 cases (95% CI, 32,040-45,856). The average age was 43, 77.8% of patients were male, 55.4% of foreign bodies were sexual devices, and 40.8% required hospitalization. The incidence of rectal foreign bodies increased from 1.2 per 100,000 in 2012 to 1.9 per 100,000 in 2021 (R² = 0.84, P<  0.01). 

The age distribution of males is bimodal, peaking in the fifth decade, whereas the age distribution of females is right-skewed, with a height in the second decade. As compared to sexual devices, female sex (odds ratio [OR] = 0.4; 95% CI = 0.2–0.6), balls/marbles (OR = 0.2; 95% CI = 0.05–0.6), and drugs/paraphernalia (OR = 0.1; 95% CI = 0.05–0.4) are associated with decreased odds of hospitalization. From 2012 to 2021, both males and females presented with rectal foreign bodies at emergency departments in the United States. These epidemiologic estimates for a complex form of anorectal trauma provide emergency medicine, surgery, and radiology trainees with preclinical information.

Source: sciencedirect.com/science/article/abs/pii/S0735675723001535