３年間にわたり治癒しなかった宿便性直腸潰ようの１例

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  • A Case of Rectal Stercoral Ulcer Intractable for More Than 3 Years.

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An 85-year-old bedridden female had been suffering from constipation with fecal incontinence, and was referred to our hospital because of bloody stool and rectal ulcer in May, 1994. She had past illness including uterine cancer, diabetes mellitus, congestive heart failure due to atrial fibrillation, and recent right hemiplegia due to cerebral infarction. Colonoscopic examination revealed a sharply-demarcated giant, shallow ulcer occupying the posterior half of the circumference of the rectum, but the colon was otherwise normal. Histologically, the biopsy specimens showed nonspecific severe chronic active inflammation without granulomas or fibromuscular obliteration. Based on the diagnosis of stercoral ulcer, her bowel habit had been controlled conservatively, and the ulcer temporarily healed in 3 months. In spite of good bowel habit, however, the rectal ulcer recurred at the same site in March, 1995, and did not heal. She died from heart failure in August, 1997.<BR>A rare case of rectal stercoral ulcer, in which the first temporal healing had been followed by a subsequent long-standing course of the open ulcer was reported. In the present case, the intractability of the ulcer was assumed to be due to advanced age associated with severe heart and vascular disorders.

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