A patient with rectal ulcer with severe stenosis presenting with perforated peritonitis

We report a patient with rectal ulcer with severe stenosis, who underwent u rgent surgical treatment for perforated peritonitis. The 54-year-old man su ddenly developed cramping abdominal pain and fever while hospitalized, with signs of peritoneal irritation. An emergency laparotomy was performed, and severe stenosis of the rectum and a perforated lesion on the oral side app roximately 10 cm distant from the stenosis were found, with massive abdomin al purulent fluid. He was treated by rectosigmoid colon resection with tran sverse colon loop colostomy. Histopathologically, the stenosis was caused b y ulceration extending to all muscular layers of the rectum, with inflammat ory changes. Benign rectal stenosis is so rare that differential diagnosis from malignancy may be difficult when there are inflammatory changes in the surrounding tissues. However, it is necessary to keep in mind the likeliho od of this disease in differentiation from rectal cancer.