The management of fecal incontinence is a struggle to maintain patient hygiene and limit the transmission of nosocomial infections. Intrarectal devices that cause diversion and collection of the fecal stream have been used with increasing frequency. This method can effectively control patient waste if used in an appropriate setting. We examine a series of 3 patients in whom rectal trauma resulting in life-threatening hemorrhage was associated with use of the ConvaTec Flexi-Seal fecal management system. In 2 patients there was a history of traumatic removal, and the third developed a rectal pressure ulcer associated with use of this device. All 3 patients required surgical or endoscopic intervention to achieve hemostasis. Although effective, the Flexi-Seal fecal management system should be used with caution to avoid rectal trauma. Injury is most likely to occur because of traumatic removal or rectal ulceration secondary to pressure necrosis.
Western Reserve Care System/Northeast Ohio Universities College of Medicine, Youngstown, Ohio
Financial Disclosure: None reported.
Presented at the meeting of the Chicago Society of Colon and Rectal Surgeons, Chicago, IL, April 3, 2009.
Correspondence: Dorothy Sparks, M.D., Department of Surgery, Western Reserve Care System/Northeast Ohio Universities College of Medicine, 500 Gypsy Ln, Youngstown, OH 44501. E-mail: Afirebrand@gmail.com