# Surgical Management for Recurrent Bleeding Stercoral Ulcers

## TL;DR

This paper discusses the surgical challenges in managing rare recurrent bleeding from rectal stercoral ulcers in an elderly patient with multiple interventions.

## Contribution

The novelty lies in highlighting the rarity and management difficulties of recurrent bleeding from rectal stercoral ulcers in a high-risk patient.

## Key findings

- Multiple interventions, including endoscopic and surgical approaches, failed to control recurrent bleeding.
- Bowel resection was deemed unsuitable due to the patient's significant comorbidities.
- The case emphasizes the need for tailored approaches in managing rare rectal stercoral ulcers.

## Abstract

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.