A Case of Refractory Rectal Ulcer due to a Large Amount of Ghost Pills

Abstract

The patient was a 71-year-old woman. She had been taking a number of medications, including sodium valproate, for psychiatric disorders. She presented to our hospital with fever and abdominal distension, and had a high inflammatory response, megacolon, and a large amount of content accumulation in the rectum. She was admitted to our hospital for treatment. Lower gastrointestinal endoscopy showed a large amount of undigested medication in the rectum, thought to be ghost pills of sodium valproate, and multiple ulcers from the sigmoid colon to the rectum. It was thought that the multiple rectal ulcers were caused by a large amount of ghost pills left in the rectum for a long time because of chronic constipation and megacolon. She underwent a sigmoid colon colostomy and intraoperative bowel cleansing using an endoscope. A large amount of ghost pills equivalent to about 1 cup of kidney dish was found in the rectum. The postoperative course was good. We report this case of refractory rectal ulcer due to a large amount of ghost pills.