| Theme |
Diagnosis and Treatment of Anorectal Disease |
| Title |
Stercoral Ulcers |
| Author |
Seiji Shimizu |
Division of Gastroenterology and Hepatology, Osaka General Hospital of West Japan Railway Company |
| Author |
Chihiro Yokomizo |
Division of Gastroenterology and Hepatology, Osaka General Hospital of West Japan Railway Company |
| Author |
Tetsuji Ishida |
Division of Gastroenterology and Hepatology, Osaka General Hospital of West Japan Railway Company |
| Author |
Takahiro Mori |
Division of Gastroenterology and Hepatology, Osaka General Hospital of West Japan Railway Company |
| Author |
Hideo Tomioka |
Division of Gastroenterology and Hepatology, Osaka General Hospital of West Japan Railway Company |
| [ Summary ] |
Stercoral ulcers are regarded as being"decubitus" ulcers caused by direct compression of the colorectal mucosa by impacted fecal masses. Reduced blood perfusion is considered to be implicated as a causative factor. This disorder tends to occur in older subjects with various underlying diseases. The histological findings are nonspecific, and the depth varies from erosion to perforation. The symptoms are hematochesia and/or abdominal pain following severe constipation. Acute abdomen develops in cases with perforations. Cases often involve the rectum, but the sigmoid colon is the most common site of perforations. Ulcers are round to irregularly shaped and do not occur in the vicinity of the dentate line. These features are distinct from those of acute hemorrhagic rectal ulcers. Surgery is necessary in cases where perforation has occured. Nonperforated cases are treated by removal of fecal masses and bowel rest. Endoscopic hemostasis is useful to control bleeding. |