Authors

Borayek Saad Borayek
Egyptian Consultant of Surgery.

Article Information

*Corresponding author: Borayek Saad Borayek, Egyptian Consultant of Surgery.

Received: July 20, 2026        |             Accepted: July 29, 2026          |            Published: August 06, 2026

Citation: Borayek S Borayek., (2026) “Delayed Diagnosis of Rectosigmoid Perforation Following Rectal Foreign Body Insertion Presenting with Septic Peritonitis: A Case Report” International Journal of Medical Case Reports and Medical Research, 5(2); DOI: 10.61148/2994-6905/IJMCRMR/0182.

Copyright:  © 2026 Borayek Saad Borayek. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: Rectal foreign bodies (RFBs) represent an uncommon but potentially life-threatening surgical emergency. Delayed diagnosis of colorectal perforation can result in fecal peritonitis, sepsis, and increased mortality.
Case Presentation: A 20-year-old previously healthy man presented with severe generalized abdominal pain, fever, tachycardia, tachypnea, and clinical features of sepsis 24 hours after rectal foreign body insertion. He had initially attended another emergency department where anal examination was reportedly normal, and he was discharged with analgesics. On admission to our institution, physical examination demonstrated generalized peritonitis with a rigid abdomen. Laboratory investigations showed leukocytosis with neutrophilia and elevated inflammatory markers. An erect chest radiograph demonstrated free subdiaphragmatic air. Following aggressive resuscitation and intravenous broad-spectrum antibiotics, emergency exploratory laparotomy was performed. A perforation at the upper rectum (rectosigmoid junction) with generalized fecal contamination was identified. Primary repair of the perforation, extensive peritoneal lavage, and a protective loop ileostomy were successfully performed. The postoperative course was uneventful, and the patient was discharged on postoperative day seven with a plan for ileostomy closure after one month.

Conclusion: A normal anal examination does not exclude proximal colorectal perforation after rectal foreign body insertion.