Snapshot quiz 14/11

Published: 08/14/2014

Authors: Aikoye A, Aravind B, Shrestha A and Basnyat P

The picture shows three thumb tacks in the rectum. These were deployed to control presacral venous bleeding during resection of the rectal cancer. Thumb tacks are useful when all else fails to control venous bleeding from sacral veins at proctectomy. Although these tacks are expected to remain at the site of deployment, they have migrated through the rectal wall to enter the lumen in this patient, resulting in intense anal pain. The patient was completely pain-free after removal of the thumb tacks.