Surgical Management for Recurrent Bleeding Stercoral Ulcers

Stercoral ulcers are a common complication from long-term constipation and generally managed on a case-to-case basis, including options such as endoscopic and surgical interventions. However, recurrent bleeding from rectal stercoral ulcers is exceedingly rare. Being an uncommon cause of long-term GI bleeding, these patients often require rapid resuscitation and hemostasis of the ulcers. We report a case of an elderly woman who presented with progressively deteriorating neurologic function and constipation who subsequently had multiple bouts of recurrent rectal bleeding despite multiple interventions performed by the Gastroenterology and General Surgery teams including endoscopic control with probe cautery and surgical approach with oversewing the vessel. With recurrent bleeding, surgical options, such as bowel resections, can be futile and harmful due to the significant comorbidities often associated with such patients.