We report the case of a 44-year-old male patient with a single history of CMV colitis who responded well to treatment with ganciclovir.
She came to the emergency room for diarrhea lasting 48 hours, with blood streams in the last stools, with no other associated symptoms.
Blood count, renal and hepatic function were normal, with a slight increase in C-reactive protein (1.6 mg/dl).
Abdominal X-ray showed no significant changes.
Reinterrupting the patient reported in the last 5 days intake of two grains.
A rectal examination revealed a hard fecal mass, which was extracted manually.
The feces contained multiple grain seeds.
The first rectal vein was visualized only in a large rectal ampulla ulcer, covered with fibrin and covered the entire circumference, from the pectinate line up to 2 cm and some ulcerated.
The presence of cytomegalovirus was ruled out by histological study (with immunohistochemical techniques).
After fecaloma disimpaction, the patient remained asymptomatic.
It was established the diagnosis of diarrhea due to rebound secondary to fecal impaction by grain seeds, with secondary traumatic rectal ulcer.
