Background: The nonspecific bowel ulcer is extremely rare in childhood beyond the neonatal period. The etiology of it is still unknown. Rectal bleeding and perforation are complications of the ulcer.
Case Report: A five-years-old boy who had serious rectal bleeding and bowel perforation due to a huge colonic ulcer was presented. Right hemicolectomy was performed for the treatment. No ulcer recurrence was observed three years after the operation.
Conclusions: If there is a serious rectal bleeding in a child with or without pneumoperitoneum, one should be suspect of complicated colonic ulcer. The diagnosis and treatment can be made successfully with surgical intervention.

Keywords: colonic ulcer, bowel perforation, rectal bleeding