title: [Actinic enteritis as a cause of digestive bleeding of obscure origin].
abstract: Chronic actinic enteritis is a malfunction of the small bowel, occurring in the 6 months post-radiotherapy, and it can be manifestated as malabsortion, stenosis, fistula formation, local abscesses, perforation and bleeding, We report a case of an elderly patient who presents an episode of obscure gastrointestinal bleeding (OGIB) secondary to actinic enteritis. She is a 64-year- old female patient with the past medical history of cervical cancer who received radiotherapy and brachytherapy. One year after the treatment, the patient presents a chronic episode of melena and symptomatic anemia and 1 week before the admission she had hematochezia. At admission she has hemodynamic instability with a hemoglobin value of 2.7 gr/dl. We did an upper endoscopy, a colonoscopy and abdomino-pelvic tomography without any findings of the bleedingâ€™s source. Reason why an endoscopic capsule was done, showing bleeding areas in the medial and distal small bowel. The patient had another gastrointestinal bleeding requiring a surgery where they decide to do a resection of the small bowel and a right hemicholectomy. The pathology was compatible with actinic enteritis. The patient after the surgery had a torpid evolution, and finally dies. We describe this case and do a review of all the existent data around the world, because is the first case reported in Peru of an actinic enteritis as a cause of OGIB.
authors.affiliation: Hospital Nacional Cayetano Heredia. Lima, Perú.
authors.forename: Luis
authors.initials: L
authors.lastname: Vásquez
authors.affiliation: Hospital Nacional Cayetano Heredia. Lima, Perú.
authors.forename: Julissa
authors.initials: J
authors.lastname: Guevara
authors.affiliation: Hospital Nacional Cayetano Heredia. Lima, Perú.
authors.forename: Victor
authors.initials: V
authors.lastname: Aguilar
authors.affiliation: Hospital Nacional Cayetano Heredia. Lima, Perú.
authors.forename: Monica
authors.initials: M
authors.lastname: Menéndez
authors.affiliation: Hospital Nacional Cayetano Heredia. Lima, Perú; Universidad Peruana Cayetano Heredia. Lima, Perú.
authors.forename: Eduar
authors.initials: E
authors.lastname: Bravo
authors.affiliation: Universidad Peruana Cayetano Heredia. Lima, Perú.
authors.forename: Patricia
authors.initials: P
authors.lastname: Guzman Rojas
authors.affiliation: Universidad Peruana Cayetano Heredia. Lima, Perú.
authors.forename: Catherina
authors.initials: C
authors.lastname: Pichilingue
authors.affiliation: Hospital Nacional Cayetano Heredia. Lima, Perú.
authors.forename: Arturo
authors.initials: A
authors.lastname: Zegarra
authors.affiliation: Universidad Peruana Cayetano Heredia. Lima, Perú.
authors.forename: Jorge
authors.initials: J
authors.lastname: Huerta-Mercado
authors.affiliation: Hospital Nacional Cayetano Heredia. Lima, Perú.
authors.forename: José
authors.initials: J
authors.lastname: Pinto
authors.affiliation: Hospital Nacional Cayetano Heredia. Lima, Perú; Universidad Peruana Cayetano Heredia. Lima, Perú.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Prochazka
authors.affiliation: Hospital Nacional Cayetano Heredia. Lima, Perú.
authors.forename: Vanessa
authors.initials: V
authors.lastname: Valenzuela
authors.affiliation: Universidad Peruana Cayetano Heredia. Lima, Perú.
authors.forename: Alejandro
authors.initials: A
authors.lastname: Bussalleu
mesh_terms: D053704:Capsule Endoscopy; D017809:Fatal Outcome; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D007079:Ileitis / Q000000981:diagnostic imaging* / Q000209:etiology; D008875:Middle Aged; D011832:Radiation Injuries / Q000150:complications / Q000000981:diagnostic imaging*; D011878:Radiotherapy / Q000009:adverse effects*