A special circumstance is assault. Patients should be asked if foreign body is the result of assault, as more serious injuries are seen in these patients. Legal authorities should be notified. Vital signs and general appearance will indicate if a resuscitation is required, as fever or hypotension may be indicative of infection or bleeding. An abdominal exam should be performed.
Absent bowel sounds, rigidity or peritoneal signs indicate probable perforation.
The foreign body, especially if large or in a high-lying position, can occasionally be palpated. A rectal examination is indicated in patients who present with abdominal complaints. In general, it should be deferred in patients with known or suspected rectal foreign bodies, especially in prisoners or psychiatric patients, until after the location and type of foreign body is ascertained, radiographically. In some cases, dangerous objects such as guns or sharp objects, such as needles or razors, are inserted rectally in an attempt to hide the object, or in the case of psychiatric patients, to injure the examiner. The main purpose of the rectal exam is to check for presence of blood and position of the foreign body.