1988 Volume 30 Issue 12 Pages 3106-3115
Recently the authors encountered seven cases of acute hemorrhagic colitis during one-year period. The clinical, endoscopic and pathologic findings of seven cases were characteristic. Constipation, troublesome defecation, abdominal pain and rectal bleeding were four major clinical features of this disease. Urgent sigmoidoscopies, which were perfomed in the first 48 hours, revealed superficial longitudinal ulcers of a sigmoid colon in 6 cases and a maplike ulcer of rectum in one case. The longitudinal ulcers changed to the map-like ones in the proximal portion. All ulcers were segmental. The specimen of the ulcer revealed four hist-pathologic characteristics. These were a superficial denuded mucosa, an irregular line of muscularis mucosae, an abutting glandular element in the submucosal area and a foreign body in the denuded mucosa which was probably a fecal material. All cases were almost in good conditions and not bed ridden. They ranged from 34 to 82 in age and had no severe associated diseases. They recovered in several weeks by only supportive cares. These 7 cases have the same clinical, endoscopic and pathologic findings. Therefore, these should be caused by the same disease prosess. The cause of this disease is thought to be impacted fecal materials, troublesome defecation and mechanical pressure effect to the mucosa. We propose to call these colitis the stercoral ulcer in the view of the pathologic findings. Although our cases of stercoral ulcer are different from those described by Grinvolsky in many aspects, these are better to be called under the same name. In our country papers of stercoral ulcer have not been published. And some cases of transient type of ischemic colitis seemed to belong to the same entity of our cases of stercoral ulcer. The entity of ischemic colitis is still controversial and it may include several types of colitis. The stercoral ulcer should be distinguished from the ischemic colitis. This is the first report, describing the clinical, endoscopic and pathologic features of stercoral ulcer in this country.
