title: Argon plasma coagulation of hemorrhagic solitary rectal ulcer syndrome.
abstract: Solitary ulcer syndrome (SUS) is a rare disorder that may provoke hematochezia. Argon plasma coagulation (APC) is used in a wide range of gastrointestinal bleeding. We experienced APC in a patient with a bleeding gigantic SUS: a 64-year-old woman who developed a SUS at 60. After 3 years, recurrent hematochezia, secondary anemia, and rectal pain occurred. Endoscopy revealed a large rectal bleeding ulcer. Moreover, the pain led the patient to assume analgesics. These conditions stimulated us to treat this ulcer with APC within 4 sessions; each session spaced out at 30-day intervals. The patient experienced and maintained the following benefits: (1) resolution of bleeding and secondary anemia after the first session, (2) reduction of ulcer depth, disappearance of pain and analgesic withdrawal at the end of the cycle, (3) almost complete endoscopic healing of the ulcer after 9 months of follow-up. This experience suggests that APC may represent a therapeutic approach for bleeding SUS even if controlled studies are necessary before recommending it as acceptable treatment.
authors.affiliation: Gastroenterology Unit, AOU "Ospedali Riuniti" of Foggia, Italy.
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Stoppino
authors.forename: Rosario
authors.initials: R
authors.lastname: Cuomo
authors.forename: Paolo
authors.initials: P
authors.lastname: Tonti
authors.forename: Marco
authors.initials: M
authors.lastname: Gentile
authors.forename: Vincenzo
authors.initials: V
authors.lastname: De Francesco
authors.forename: Nicola
authors.initials: N
authors.lastname: Muscatiello
authors.forename: Carmine
authors.initials: C
authors.lastname: Panella
authors.forename: Enzo
authors.initials: E
authors.lastname: Ierardi
mesh_terms: D001128:Argon; D001706:Biopsy; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D006484:Hemorrhoids / Q000601:surgery; D006801:Humans; D007413:Intestinal Mucosa / Q000473:pathology / Q000601:surgery; D017075:Laser Coagulation / Q000379:methods*; D008875:Middle Aged; D010146:Pain / Q000209:etiology; D011183:Postoperative Complications / Q000175:diagnosis / Q000473:pathology / Q000601:surgery; D011351:Proctoscopy; D012002:Rectal Diseases / Q000175:diagnosis / Q000601:surgery*; D012007:Rectum / Q000473:pathology / Q000601:surgery; D013577:Syndrome; D014456:Ulcer / Q000175:diagnosis / Q000601:surgery*
chemical_list: D001128:Argon