Case Report: Transanal extraction combined with wound management for a broken glass foreign body and associated rectal injuries.

Background: Rectal foreign bodies (RFBs) have become a relatively common yet often underestimated clinical entity. Fragile and sharp objects like glass pose a perplexing challenge, as unsafe removal may lead to complications or even life-threatening injuries. This report details the management of a complex case involving a broken glass rectal foreign body with associated rectal injuries. Case presentation: A 55-year-old male was brought to the emergency department complaining of rectal fullness and bleeding after inserting a glass cup. Plain abdominal X-ray film showed an irregular dense shadow approximately 7 cm in length within the pelvis, with no evidence suggesting bowel perforation. A rectal digital examination (DRE) revealed the presence of an intrarectal foreign body with suspected rectal mucosal injury. The foreign body was successfully removed transanally under spinal anesthesia. Assessment revealed rectal lacerations without active bleeding. To mitigate the risk of entrapping minute glass fragments, the wounds were debrided and left open for secondary intention healing. Furthermore, we selectively ligated the congested and redundant mucosal folds adjacent to the wounds to promote healing. The postoperative course was uneventful. Flexible proctosigmoidoscopy at two-month follow-up demonstrated complete mucosal healing without complications. Conclusions: The management of broken glass RFBs with associated rectal injuries requires a systematic approach involving precise diagnosis, cautious intervention, and attentive postoperative care. This case describes a distinct management strategy for such injuries and will provide a reference for clinicians facing similar clinical scenarios.