A CASE REPORT OF STERCORAL ULCER WITH HUMAN T-CELL LYMPHOTROPIC VIRUS TYPE I (HTLV-1)-ASSOCIATED MYELOPATHY (HAM)

Abstract

Human T-cell lymphotropic virus type I (HTLV-1)-associated myelopathy (HAM) is considered as autoimmune disease secondary to HTLV-I virus infection. We experienced a patient with HAM who was diagnosed as having stercoral ulcer due to anal bleeding by barium enema and colonoscopy. and was cured by conservative therapy. The patient was 66-year-old woman who had been suffering from HAM since 58 years of age, and was under treatment for chronic progressive spastic paraparesis, neurogenic bladder and constipation. She noticed dark red melena at evacuation in January, 1997, and was seen at the hospital. Colonoscopy and barium enema revealed a large and deep ulcerative lesion about 3cm in diameter at the left side of the upper rectum. The patient was successfully treated with conservative therapy. As this large ulcerative lesion was healed with scar after two months, this lesion was thought to be stercoral ulcer with the penetration into the mesorectum.