title: [Radiation proctitis: description of two cases refractory to pharmacological treatment].
abstract: Radiation proctitis, is a relatively frequent complication resulting from the direct or collateral irradiation of the rectum in radiotherapy treatment for genito-urinary or anorectal malignancies. The main symptoms are diarrhoea, tenesmus, proctorrhagia, anal pain, mucorrhoea and faecal incontinence. The evolution of chronic radiation proctitis requires treatment for related anaemia, anal incontinence and micturition disorders. The approach and type of treatment depend on the severity of the symptoms and on the endoscopic aspect, in relation to the response to previous medical therapy performed. In our experience, endoscopic treatment is the best choice in the presence of ongoing bleeding and the possible development of severe anaemia. The surgical option is mandatory in patients at high risk of sepsis, requiring a faecal diversion constructed using the Hartmann technique. We report two cases, observed during the last two years, one treated with endoscopic bipolar coagulation and the other with a double urinary and faecal diversion.
authors.affiliation: U O C Chirurgia 2, Dipartimento di Chirurgia e Bioingegneria, Azienda Ospedaliera Universitaria Senese, Siena.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Piccolomini
authors.forename: Niccolò
authors.initials: N
authors.lastname: Francioli
authors.forename: Luigi
authors.initials: L
authors.lastname: Verre
authors.forename: Alfredo
authors.initials: A
authors.lastname: Guarnieri
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Vuolo
authors.forename: Leonardo
authors.initials: L
authors.lastname: Di Cosmo
authors.forename: Andrea
authors.initials: A
authors.lastname: Tirone
authors.forename: Raffaele
authors.initials: R
authors.lastname: Chieca
authors.forename: Enrico
authors.initials: E
authors.lastname: Tucci
authors.forename: Anton Ferdinando
authors.initials: AF
authors.lastname: Carli
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000209:etiology / Q000628:therapy; D005938:Glucocorticoids / Q000627:therapeutic use; D016558:Hemostasis, Endoscopic / Q000379:methods; D006801:Humans; D017075:Laser Coagulation / Q000379:methods; D008297:Male; D011349:Proctitis / Q000209:etiology* / Q000628:therapy*; D011471:Prostatic Neoplasms / Q000532:radiotherapy*; D011878:Radiotherapy / Q000009:adverse effects; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012812:Sigmoidoscopy / Q000379:methods; D016896:Treatment Outcome
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D005938:Glucocorticoids