A case of haemorrhagic radiation proctitis: successful treatment with argon plasma coagulation.
Argon plasma coagulation (APC) has been used extensively for a wide range of indications in gastrointestinal endoscopy. We describe a case of haemorrhagic radiation proctitis treated successfully with APC. A 54-year-old Japanese woman presented with daily rectal bleeding 4 months after cessation of radiotherapy for uterine cancer. Colonoscopic examination showed friable bleeding teleangiectasias in the rectum. Her haemoglobin level was decreased to 5.4 g/dl, requiring frequent blood transfusions. Endoscopic APC set at 1.2 l/min and 45 W was applied. After four treatment sessions without any complications, the patient showed complete resolution of haematochezia and subsequent haematological improvement. Standard and magnifying endoscopic follow-up revealed complete eradication of the vascular lesions and cicatrization of the treated areas, and mucosal covering with normal crypt lining. Endoscopic APC is an effective and well-tolerated treatment modality for the management of haemorrhagic proctitis.
Isomoto
Hajime
H
Second Department of Internal Medicine, Nagasaki University School of Medicine, Nagasaki, Japan. hhisomot@net.nagasaki-u.ac.jp
Hazama
Hiroaki
H
Shikuwa
Saburo
S
Omagari
Katsuhisa
K
Mizuta
Yohei
Y
Murase
Kunihiko
K
Murata
Ikuo
I
Kohno
Shigeru
S
D001128:Argon / Q000627:therapeutic use; D002277:Carcinoma / Q000175:diagnosis / Q000532:radiotherapy; D003113:Colonoscopy; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000209:etiology*; D006801:Humans; D017075:Laser Coagulation / Q000379:methods*; D008875:Middle Aged; D011349:Proctitis / Q000175:diagnosis / Q000209:etiology* / Q000601:surgery*; D011829:Radiation Dosage; D011832:Radiation Injuries / Q000175:diagnosis*; D012007:Rectum / Q000528:radiation effects / Q000601:surgery; D018570:Risk Assessment; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis / Q000532:radiotherapy
D001128:Argon