Thinking outside the rectum: a unique approach to the retrieval of gluteal foreign bodies

Penetrating gluteal wounds with retained foreign bodies are relatively uncommon and therefore there is no agreed-upon method of extraction. Retrieval of such objects can be difficult to achieve due to imperfect anatomy and a lack of clear planes across which the objects traverse, sometimes requiring novel techniques for foreign body retrieval. We saw a 37-year-old male with a 2-month history of a draining abscess on his right buttock. CT and manual probing of the wound demonstrated a 5-cm tract with a possible foreign body within. We took the patient to the operating room for exploration of the tract under general anesthesia, allowing for palpation of the foreign object as well as digital rectal exam, which identified an object passing posterior to the rectum. A cystoscope was used to widen the tract and allow for better visualization. Grasping forceps were inserted into the cystoscope and used to capture/retrieve the object.