Complete circumferential rectal ulceration and haemorrhage secondary to the use of a faecal management system

Abstract
This structured case report is a brief case report describing an episode of complete circumferential rectal ulceration and haemorrhage secondary to the use of a faecal management system. An elderly lady was admitted for elective cardiac surgery. Prior to admission, the patient was taking warfarin in view of her atrial fibrillation. Following surgery, the patient developed faecal incontinence, which was managed with a faecal management system. However, the patient subsequently developed massive rectal haemorrhage from an area of complete circumferential ulceration in the rectum. This ulceration resulted from pressure necrosis secondary to the faecal management system balloon placed in the patient’s rectum. The implication for care is that faecal management systems are an important adjunct in the management of faecal incontinence, but caution must be exercised with prolonged use, particularly in anticoagulated patients.