title: 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.
authors.affiliation: General Surgery, University Hospitals of South Manchester Academic Surgery, 2nd Floor ERC, Southmoor Road, Manchester M23 9LT, UK.
authors.forename: Hudhaifah
authors.initials: H
authors.lastname: Shaker
authors.affiliation: Oxford University Clinical Academic Graduate School, Oxford, UK.
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Maile
authors.affiliation: University Hospitals of South Manchester, UK.
authors.forename: Karen J
authors.initials: KJ
authors.lastname: Telford
keywords: CT angiography; anticoagulation; faecal incontinence; haemorrhage; rectal ulceration