Case Report: Massive rectal bleeding from stercoral ulcers in a pediatric patient

A 10-year-old patient was admitted to the pediatric sub-intensive care unit due to massive rectal bleeding and severe acute anemia. His medical background included Asperger syndrome and a history of chronic constipation not adequately addressed by medical therapy. Colonoscopy showed two deep ulcers in the rectum and sigmoid colon of approximately 4 cm in diameter, which were diagnosed as stercoral ulcers related to stercoral colitis, a rare inflammatory form of colitis that occurs in patients with refractory constipation. Stercoral colitis has been mainly described in elderly patients with dementia or in bedbound patients and only occasionally in adults with psychiatric disorders. To the best of our knowledge, this is the first case of massive rectal bleeding from stercoral ulcers in a pediatric patient.