1/8. Treatment of radiation-induced proctitis with sucralfate enemas.OBJECTIVE: To report a case of radiation-induced proctitis treated with sucralfate enemas. CASE SUMMARY: A 77-year-old white woman was transferred from an acute care institution to our inpatient rehabilitation unit with impaired mobility and reduced activities of daily living. Her condition was secondary to myopathy and peripheral neuropathy associated with postradiation chemotherapy and metastatic ovarian carcinoma. During her stay, she developed hematochezia and pain secondary to a diagnosis of radiation-induced proctitis. Her hemoglobin had reached a nadir of 7.3 g/dL. The patient received blood transfusions and was started on 10% w/v sucralfate retention enemas 2 g/20 mL daily for 12 consecutive days. She was symptom-free at discharge, with a stable hemoglobin of approximately 10 g/dL. DISCUSSION: proctitis is a common adverse effect of radiotherapy to the lower abdomen and pelvic area. sucralfate is an aluminum complex that acts as a local cytoprotective agent against ulceration of the gastrointestinal mucosal lining. Rectal administration of sucralfate, as described in our patient and reported in published case studies, may provide an alternative therapy for patients with radiation-induced proctitis. CONCLUSIONS: sucralfate suspension enemas provide a viable treatment option in patients who are intolerant of, refractory to, or not candidates for standard therapy for radiation-induced proctitis.- - - - - - - - - - ranking = 1keywords = radiation-induced (Clic here for more details about this article) |
2/8. Surgical treatment of recalcitrant radiation-induced gastric erosions.BACKGROUND: Uncontrolled bleeding as a result of radiation gastritis in patients who have pharyngo-laryngo-esophagectomy and gastric pull-up is seldom reported. Surgical resection in the management of this condition has rarely been described. METHOD: A 66-year-old man with hypopharyngeal cancer was treated by pharyngo-laryngo-esophagectomy and gastric transposition. He received postoperative radiotherapy and had recurrent hemorrhagic gastritis, necessitating surgical resection. The manubrium was resected to access the mediastinal part of the gastric conduit. The diseased part of the gastric conduit was removed and a free jejunal graft was interposed to replace the resected stomach. RESULTS: Manubrial resection offered adequate access to the stomach transposed in the mediastinum, and the life-threatening bleeding gastritis was successfully controlled by surgical resection. CONCLUSION: Surgical resection of the radiation-damaged transposed stomach through a manubrial resection approach can safely be performed. Free jejunal graft is the choice of reconstruction of the circumferential defect.- - - - - - - - - - ranking = 0.5keywords = radiation-induced (Clic here for more details about this article) |
3/8. radiation-induced aortoesophageal fistula: an unusual case of massive upper gastrointestinal bleeding.Aortoesophageal fistula (AEF) is an unusual cause of massive upper gastrointestinal bleeding. Thoracic aortic aneurysm is the most common etiology of primary AEF followed by, respectively, foreign body ingestion, esophageal malignancy, and postsurgical fistulization. radiation-induced damage to the great vessels is well recognized and some authors in the past have suggested that AEF may be caused by radiotherapy. However, previous case reports of radiation-induced AEF involved patients who received radiotherapy for esophageal carcinoma, and precise histopathologic differentiation between AEF secondary to esophageal malignancy and that induced by radiation was difficult. We present here the unique case of a patient with a non-esophageal carcinoma who received radiotherapy before the development of an AEF, thus providing further evidence for the role of radiation injury in the development of this condition. As well, we discuss current opinion regarding etiology, clinical presentation, diagnosis, and management of this entity.- - - - - - - - - - ranking = 0.125keywords = radiation-induced (Clic here for more details about this article) |
4/8. Hyperbaric oxygen treatment of hemorrhagic radiation-induced gastritis after esophagectomy.My colleagues and I present 2 cases of hemorrhagic postesophagectomy gastritis after chemoradiotherapy for esophageal cancer. On the basis of the location of the gastritis (lesser curve and midstomach) and the classic radiation injury appearance, radiation damage was believed to be the cause. In both patients, hyperbaric oxygen therapy rapidly arrested bleeding. This is the first description in which hyperbaric oxygen therapy was used to treat hemorrhagic postesophagectomy gastritis.- - - - - - - - - - ranking = 0.5keywords = radiation-induced (Clic here for more details about this article) |
5/8. Formalin treatment of radiation-induced hemorrhagic proctitis.A 71-year-old man developed severe hemorrhagic proctitis 1 year after pelvic irradiation for carcinoma of the urinary bladder. Conservative treatment as well as performance of a colostomy failed to control the rectal bleeding. After irrigation of the rectum with a formalin solution the bleeding stopped, and no recurrence has been observed for the next 14 months.- - - - - - - - - - ranking = 0.5keywords = radiation-induced (Clic here for more details about this article) |
6/8. radiation-induced solitary rectal ulcer.A case of radiation-induced solitary rectal ulcer is presented. The unusual posterior location with involvement of the internal iliac artery produced massive lower intestinal hemorrhage. Temporary control was obtained with percutaneous arterial catheter embolization, but definitive control necessitated surgical resection.- - - - - - - - - - ranking = 0.125keywords = radiation-induced (Clic here for more details about this article) |
7/8. Estrogen-progestin therapy and coronary heart disease in radiation-induced rectal telangiectases.We describe two elderly men with preexisting coronary heart disease (CHD) and prostatic carcinoma who presented with intractable anemia due to radiation-induced rectal telangiectases and bleeding. Remission of the bleeding was achieved in both patients by treatment with an estrogen-progestin preparation. However, aggravation of the CHD occurred in both patients. We believe that estrogen-progestin preparations have a potential in the treatment of men with radiation-induced rectal telangiectases, but additional studies are needed to evaluate their long-term effects and optimal dose.- - - - - - - - - - ranking = 0.75keywords = radiation-induced (Clic here for more details about this article) |
8/8. fluoroscopy-induced radiodermatitis after transjugular intrahepatic portosystemic shunt.Transjugular intrahepatic portosystemic shunt is a nonsurgical procedure used to manage the complications of portal hypertension. This report describes three cases of fluoroscopy-induced radiodermatitis after transjugular intrahepatic portosystemic shunt and reviews the characteristics and treatment of radiation-induced skin reactions.- - - - - - - - - - ranking = 0.125keywords = radiation-induced (Clic here for more details about this article) |