Other nonneoplastic

Stercoral ulcer

Topic Completed: 19 February 2021

Minor changes: 25 February 2021

Copyright: 2003-2021,, Inc.

PubMed Search: Stercoral ulcer

Raul S. Gonzalez, M.D.
Page views in 2020: 2,019
Page views in 2021 to date: 1,895
Cite this page: Gonzalez RS. Stercoral ulcer. website. Accessed October 25th, 2021.
Definition / general
  • Ulceration of colonic mucosa secondary to impacted feces
Essential features
  • Inspissated feces can cause rectosigmoid ulceration in elderly patients
  • May perforate and lead to death
  • Usually in rectosigmoid
  • Impacted feces stagnate, eventually eroding and ulcerating underlying mucosa
Clinical features
  • Proposed criteria for stercoral perforation: round / ovoid antimesenteric perforation > 1 cm, associated with fecaloma, showing necrosis / ulcer / chronic inflammation microscopically (Dis Colon Rectum 2000;43:991)
Case reports
Gross description
  • Sharply demarcated ulcer(s)
  • Perforation may be present
Microscopic (histologic) description
  • Colonic ulceration / perforation
  • Fecal material may or not may be observable microscopically
Microscopic (histologic) images

Contributed by Raul S. Gonzalez, M.D.
Biopsy of colonic ulcer

Biopsy of colonic ulcer

Sample pathology report
  • Transverse colon, ulcer, biopsy:
    • Colonic mucosa with ulceration and embedded fecal material (see comment)
    • Comment: The findings are suggestive of a stercoral ulcer.
Differential diagnosis
Additional references
Board review style question #1

If left unattended, colonic stercoral ulcers can lead to

  1. Inflammatory bowel disease
  2. Malignancy
  3. Malnutrition
  4. Perforation
Board review style answer #1
D. Perforation

Comment Here

Reference: Stercoral ulcer
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