title: Hemorrhagic radiation gastritis successfully treated with repeated intra-arterial steroid infusions.
abstract: Intra-arterial steroid infusion therapy has previously been shown to be effective for inflammatory bowel disease; however, few cases in which it has been used for the treatment of hemorrhagic radiation gastritis have been reported. We report the case of a 70-year-old Japanese man with hemorrhagic radiation gastritis induced by radiation therapy for para-aortic lymph node metastases of hepatocellular carcinoma. Two months after completing radiation therapy, acute persistent bleeding occurred in the gastric irradiation area. Although argon plasma coagulation was performed five times over a month, the bleeding continued and the patient showed persistent anemia that required 50 units of blood transfusion. Finally, the patient was given intra-arterial steroid infusions through the right gastric artery and the right gastroepiploic artery. After three intra-arterial steroid infusions, the melena stopped, and the anemia no longer progressed. Hemorrhagic radiation gastritis was successfully treated with repeated intra-arterial steroid infusions through the regional vessels to the gastric mucosa. Repeated intra-arterial steroid infusions could be a clinically useful option for the treatment of intractable bleeding from radiation gastritis.
authors.affiliation: Hepatology Division, Department of Internal Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashiku, Hamamatsu, Shizuoka, 431-3192, Japan. kaz110yk@gmail.com.
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Kawata
authors.affiliation: Hepatology Division, Department of Internal Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashiku, Hamamatsu, Shizuoka, 431-3192, Japan.
authors.forename: Yoshimasa
authors.initials: Y
authors.lastname: Kobayashi
authors.affiliation: Hepatology Division, Department of Internal Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashiku, Hamamatsu, Shizuoka, 431-3192, Japan.
authors.forename: Kenichi
authors.initials: K
authors.lastname: Souda
authors.affiliation: Hepatology Division, Department of Internal Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashiku, Hamamatsu, Shizuoka, 431-3192, Japan.
authors.forename: Kinya
authors.initials: K
authors.lastname: Kawamura
authors.affiliation: Hepatology Division, Department of Internal Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashiku, Hamamatsu, Shizuoka, 431-3192, Japan.
authors.forename: Yurimi
authors.initials: Y
authors.lastname: Takahashi
authors.affiliation: Hepatology Division, Department of Internal Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashiku, Hamamatsu, Shizuoka, 431-3192, Japan.
authors.forename: Hidenao
authors.initials: H
authors.lastname: Noritake
authors.affiliation: Hepatology Division, Department of Internal Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashiku, Hamamatsu, Shizuoka, 431-3192, Japan.
authors.forename: Shinya
authors.initials: S
authors.lastname: Watanabe
authors.affiliation: Hepatology Division, Department of Internal Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashiku, Hamamatsu, Shizuoka, 431-3192, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Suehiro
authors.affiliation: Department of Radiology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashiku, Hamamatsu, Shizuoka, 431-3192, Japan.
authors.forename: Mika
authors.initials: M
authors.lastname: Kamiya
authors.affiliation: Department of Radiology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashiku, Hamamatsu, Shizuoka, 431-3192, Japan.
authors.forename: Shuhei
authors.initials: S
authors.lastname: Yamashita
authors.affiliation: Department of Radiology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashiku, Hamamatsu, Shizuoka, 431-3192, Japan.
authors.forename: Takasuke
authors.initials: T
authors.lastname: Ushio
authors.affiliation: Hepatology Division, Department of Internal Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashiku, Hamamatsu, Shizuoka, 431-3192, Japan.
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Nakamura
keywords: Argon plasma coagulation; Hemorrhagic radiation gastritis; Intra-arterial steroid infusions