Bharath stated that the introduction of foreign bodies into one’s own body is one of the uncommon types of self-mutilation. There is a relative dearth of literature discussing its predisposing factors, complications and management. Children commonly swallow foreign bodies, most of these are accidental ingestion. In adolescents, intentional foreign body insertion often reflects risk taking behaviour. Adults may suffer from co-morbid psychiatric disease, harbour lingering curiosities that manifest as experimentation or as auto-eroticism. While psychiatric causes have been hypothesized as the underlying aetiology, its incidence in this cohort remains to be established. Foreign body insertion in these individuals is associated with highly repetitive behaviour, it may occur as a response to command hallucinations, for example in schizophrenia. Foreign bodies can enter the human body by swallowing, insertion or by traumatic force, either accidental or deliberate. The authors describe two cases of foreign body insertion (a plastic bottle and sewing needles) involving the rectum and the abdomen presenting to the Emergency Department. A non-judgemental and open-minded approach is crucial, ensuring privacy, professionalism and empathy towards a patient presenting to triage as staff reactions such as titillation or disgust can impact negatively on compassionate patient care. Successful management involves a collaborative approach involving primary care physicians, emergency physicians, surgeons and psychiatrists. Even after extraction, delayed perforation or significant bleeding from the rectum may occur. Unearthing the aetiology for foreign body insertion can lead to management strategies that target the motivation for the behaviour. This paper will provide an overview of its aetiology, clinical presentation and management.
Keywords: Case report; Polyembolokoilamania; Foreign body insertion; Co-morbid psychiatric disease; Perforation