[Nonsurgical treatment of chronic radiation-induced hemorrhagic proctitis].
The incidence of radiation-induced chronic hemorrhagic proctitis is less than 10 to 20%. The onset of this proctitis is delayed relative to the radiation therapy and generally develops from 6 to 24 months later. There are numerous predisposing factors, the most important of which is the radiation therapy dose: risk increases exponentially above 40-45 Gy. Its pathophysiology involves progressive obliterating endarteritis and transmural interstitial fibrosis, which induce chronic ischemia that is irreversible and progressive during the years after radiation therapy. Its diagnosis depends most often on the combination of clinical history and typical endoscopic appearance (congestive mucosa and/or telangiectases). Topical administrative of sucralfate or corticosteroids as well as argon plasma coagulation, with formalin treatment if necessary, provides relief for most patients.
de Parades
Vincent
V
Service de proctologie médico-interventionnelle, Groupe hospitalier Diaconesses - Croix Saint-Simon, F-75012 Paris, France. proctologie@hopital-dcss.org
Bauer
Pierre
P
Marteau
Philippe
P
Chauveinc
Laurent
L
Bouillet
Thierry
T
Atienza
Patrick
P
D000897:Anti-Ulcer Agents / Q000627:therapeutic use; D002908:Chronic Disease; D003092:Colitis / Q000209:etiology / Q000628:therapy*; D005557:Formaldehyde / Q000627:therapeutic use; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000628:therapy*; D006801:Humans; D017075:Laser Coagulation; D011350:Proctocolitis / Q000209:etiology / Q000628:therapy; D011832:Radiation Injuries / Q000209:etiology / Q000628:therapy*; D011878:Radiotherapy / Q000009:adverse effects*; D011879:Radiotherapy Dosage; D012307:Risk Factors; D013392:Sucralfate / Q000627:therapeutic use; D013997:Time Factors
D000897:Anti-Ulcer Agents; D005557:Formaldehyde; D013392:Sucralfate