Constipation

Dr. Richard McCormick used ultrasound to assist in the evaluation of a patient who presented with “constipation.”  The patient was initially not forthcoming with further history.  Dr. McCormick placed the curved probe superior to the rectum, in a sagittal plane.  Can you identify the cause of the patient's discomfort?

 

Perhaps the pelvis radiograph will clarify.

 

In brief, the patient presented with abdominal pain and the images reveal why – a rectal foreign body. The ultrasound artifact is called reverberation and occurs when the US beams bounces off a highly reflective structure. This typically produces A-lines (horizontal lines) below the metallic structure.

Procedural sedation and ED retrieval were successful without complication.