Man Spontaneously Passes 25-Centimeter Rectal Object Following Three-Day Delay, Report Finds

A 10-Inch Object and a Three-Day Wait

A 51-year-old patient presented to a hospital emergency department three days after a foreign object approximately 25 centimeters long, or roughly 10 inches, was inserted into his rectum. While he remained in the emergency department, the object was expelled naturally without medical intervention, and he experienced no complications.

The case is detailed in a report published online June 16, 2026, in the International Journal of Surgery: Global Health. Three of the four authors are radiology and general surgery physicians at the B.P. Koirala Institute of Health Sciences (BPKIHS) in Dharan, Nepal, while the fourth is a radiologist at Anil Baghi Hospital in Punjab, India. According to their summary, the insertion was performed by a friend while the patient was intoxicated.

The distinguishing factor is the outcome. A large object retained for several days poses a risk of injury or perforation to the bowel wall, and patients in such situations are frequently treated with sedation, endoscopy, or surgery. This patient required none of those interventions.

Passing It Naturally Is the Exception

The report, titled “Clinical and radiological evaluation of a large rectal foreign body with spontaneous expulsion,” addresses both the diagnostic process and the unexpected resolution. “Spontaneous expulsion” denotes the patient passing the object naturally without extraction by medical staff.

The authors noted that an accurate diagnosis relies heavily on a comprehensive history and clinical examination. However, they stressed that imaging remains essential for establishing the object’s precise location, dimensions, and shape, as well as identifying any damage it may have caused.

This point is critical because certain objects are difficult to visualize. “Radiolucent foreign bodies can be particularly challenging to detect, even with advanced imaging techniques,” the authors wrote. Radiolucent materials allow X-rays to pass through, meaning specific plastics and similar substances may barely register on a standard radiograph.

A clinical review of rectal foreign body removal on NIH’s StatPearls states that plain X-rays of the abdomen and pelvis are the standard initial test but can fail to detect small or radiolucent objects. A CT scan is preferred when an object is not visible on X-ray or when clinicians suspect complications such as perforation, abscess, or obstruction.

Embarrassment Can Cost Critical Time

The Nepali team observed that there are currently no standardized medical protocols for managing rectal foreign bodies. Most, they wrote, are removed through the anus without surgery, while a minority of cases require an operation, particularly when complications such as bowel perforation, sepsis, or peritonitis develop.

StatPearls quantifies that stepwise approach. Recent analyses place the success rate of bedside removal through the anus at 60% to 75%. When an object sits too high to reach, retrieval using a flexible sigmoidoscope or colonoscope succeeds approximately 70% to 90% of the time. Open abdominal surgery, known as laparotomy, is generally reserved for unstable patients or cases where less invasive laparoscopic surgery fails.

Removal is not the conclusion of the evaluation. The MSD Manual’s professional guidance on rectal foreign bodies advises that sigmoidoscopy be performed after extraction to rule out significant rectal injury. It also highlights warning signs: sudden, excruciating pain during defecation should raise suspicion of a penetrating object, while visible bleeding may indicate a tear or perforation.

The Dharan report is not the only recent instance from Nepal in which a rectal foreign body was passed without intervention. Earlier, MedicalDaily covered a man in police custody who expelled six tramadol ampoules before planned surgical removal. The authors of that report cautioned that the result should be viewed as a fortunate outcome rather than a recommended management strategy.

A Problem U.S. Emergency Rooms See Too

StatPearls notes that some patients delay care for several days or even weeks, often due to embarrassment, and many “hesitate to disclose the true cause” of their symptoms upon reaching the emergency department.

Some patients attempt self-removal first, which can delay proper treatment and increase the risk of injury or deeper impaction. The most serious complication, according to StatPearls, is perforation leading to peritonitis, a potentially life-threatening inflammation of the abdominal lining. Other risks include bleeding, bowel obstruction, abscesses, fistulas, sepsis, and pressure necrosis, where tissue dies following prolonged compression.

The patient also matches a familiar demographic profile. StatPearls reports that most adult patients are men and that, among men, cases follow a bimodal age pattern with a significant peak in the 40s, close to this man’s age.

The case report does not frame this outcome as a strategy for others. Its conclusion centers on careful assessment, imaging, and surgery when complications such as perforation, sepsis, or peritonitis arise — the very issues that prompt medical care is designed to detect early.

Cases like this are not confined to South Asia. A 10-year review of U.S. injury surveillance data, published in Cureus in 2023 by surgeons at Riverside Community Hospital in California, identified 1,806 emergency department visits for rectal foreign bodies from 2012 through 2021. The visits were drawn from the National Electronic Injury Surveillance System, a federal database built on a nationally representative sample of U.S. hospitals.

Annual cases in that sample rose from 144 in 2012 to 236 in 2021. Approximately 65% of patients were male, and 22.4% were admitted to the hospital, while about 71% were treated and released. Massage devices and vibrators were the most frequently recorded objects, followed by jewelry and pens or pencils.

Those figures reflect visits captured by a surveillance sample, not every case nationwide. The authors also noted that the database holds little detail beyond whether a patient was released, admitted, or transferred.

For clinicians, the lesson of the Dharan case is less about the unusual exit and more about the workup: take a thorough history, image carefully, and monitor for signs of perforation. For anyone in a similar situation, the medical message is simpler. Emergency departments handle these cases regularly, and seeking care promptly gives doctors the best chance to remove an object safely. Severe abdominal pain, rectal bleeding, or fever calls for medical attention right away.

Key Questions Answered

What happened in this case?

A 51-year-old man in Nepal went to an emergency department three days after an object about 25 centimeters long was inserted into his rectum. The object was expelled naturally in the emergency department, and he had no complications.

Where was the case published?

It was published online on June 16, 2026, in the International Journal of Surgery: Global Health by physicians from BPKIHS in Dharan, Nepal, and Anil Baghi Hospital in Punjab, India.

Why is passing the object naturally unusual?

Most rectal foreign bodies are removed by doctors, typically through the anus under sedation or with an endoscope. Some require surgery, especially when the bowel is injured.

What are the main dangers of waiting to seek care?

A retained object can injure or perforate the bowel, which can lead to peritonitis, abscesses, bleeding, or sepsis. Attempts at self-removal can delay treatment and make injuries worse.

Why can imaging miss some objects?

Radiolucent materials allow X-rays to pass through, so they may not appear clearly on standard films. CT scans are preferred when an object is hard to see, or complications are suspected.

How often do U.S. emergency departments see these cases?

A 2023 review of national injury surveillance data found 1,806 emergency visits in its hospital sample from 2012 through 2021, with yearly cases rising from 144 to 236. About 22% of those patients were admitted.

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