Cases reported "Proctitis"

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1/10. 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.
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ranking = 1
keywords = radiation-induced
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2/10. A case of haemorrhagic radiation proctitis: successful treatment with argon plasma coagulation.

    argon plasma coagulation (APC) has been used extensively for a wide range of indications in gastrointestinal endoscopy. We describe a case of haemorrhagic radiation proctitis treated successfully with APC. A 54-year-old Japanese woman presented with daily rectal bleeding 4 months after cessation of radiotherapy for uterine cancer. Colonoscopic examination showed friable bleeding teleangiectasias in the rectum. Her haemoglobin level was decreased to 5.4 g/dl, requiring frequent blood transfusions. Endoscopic APC set at 1.2 l/min and 45 W was applied. After four treatment sessions without any complications, the patient showed complete resolution of haematochezia and subsequent haematological improvement. Standard and magnifying endoscopic follow-up revealed complete eradication of the vascular lesions and cicatrization of the treated areas, and mucosal covering with normal crypt lining. Endoscopic APC is an effective and well-tolerated treatment modality for the management of haemorrhagic proctitis.
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ranking = 0.00015748581812252
keywords = cancer
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3/10. Waiting-list induced proctitis: the hydrogen peroxide enema.

    hydrogen peroxide is a widely available disinfectant that has been reported to cause colitis. We report a case of a 67-year-old man who presented with an acute proctitis caused by a self-inflicted 3% hydrogen peroxide enema. The patient's intention was to cure himself of a recently diagnosed prostate cancer, because the waiting list for oncological consultation was deemed too long. The pathogenesis of hydrogen peroxide mucosal injury and a review of the literature is discussed.
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ranking = 0.00015748581812252
keywords = cancer
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4/10. paclitaxel-carboplatin induced radiation recall colitis.

    Some chemotherapeutic agents can "recall" the irradiated volumes by skin or pulmonary reactions in cancer patients who previously received radiation therapy. We report a recall colitis following the administration of paclitaxel-containing regimen in a patient who had been irradiated for a carcinoma of the uterine cervix. A 63-year-old woman underwent a Wertheim operation because of uterine cervix carcinoma. After 8 years of follow-up, a local recurrence was observed and she received curative external radiotherapy (45 Gy) to the pelvis. No significant adverse events were observed during the radiotherapy. Approximately one year later, she was hospitalized because of metastatic disease with multiple pulmonary nodules, and a chemotherapy regimen consisting of paclitaxel and carboplatin was administered. The day after the administration of chemotherapy the patient had diarrhea and rectal bleeding. Histological examination of the biopsy taken from rectal hyperemic lesions showed a radiation colitis. The symptoms reappeared after the administration of each course of chemotherapy and continued until the death of the patient despite the interruption of the chemotherapy. In conclusion, the probability of recall phenomena should be kept in mind in patients who received previously with pelvic radiotherapy and treated later with cytotoxic chemotherapy.
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ranking = 0.00015748581812252
keywords = cancer
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5/10. Supralevator abscess due to chronic rectal lymphogranuloma venereum.

    lymphogranuloma venereum (LGV) usually manifests as an inguinal syndrome, but it can also cause an anorectal syndrome that is difficult to diagnose because of its similarity to other disorders, the lack of easily available specific laboratory tests, and an assumption that it occurs only in women or homosexual men. LGV proctitis is often mild, but chronic cases can have serious complications. We describe a heterosexual Vietnamese man with a rectal stricture and supralevator abscess due to LGV proctitis whose presentation mimicked that of rectal cancer.
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ranking = 0.00015748581812252
keywords = cancer
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6/10. 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.
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ranking = 0.5
keywords = radiation-induced
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7/10. Therapeutic dosimetry for Cf-252 neutron brachytherapy of pelvic cancer.

    252Cf (Cf) was used to treat tumors of the cervix and uterus with neutron brachytherapy (NT) in an ongoing clinical trial. Tandem and ovoids insertions were used and combinations of single and multiple applications along with high dose whole pelvic irradiation. Dosimetric analysis of treated cases for patterns of tissue dose were carried out. Tissue dose for Cf-NT was, in general, high for neutron components in the central pelvis only, and fell off rapidly with distance from the applicators. The majority and balance of therapeutic dose was contributed by low linear energy transfer (LET) high energy photon beam radiation to the whole pelvis. Comparison with fast neutron beam therapy (NBT) isodose curves showed that much more homogeneous neutron dose was delivered to the pelvic tumor and organs by NBT. Complication frequency has been reported to be higher for neutron beam therapy than for Cf-NT. It appears that the higher integral neutron biological dose to normal tissues for NBT compared to intracavitary Cf-NT probably contributed to the frequency of side effects.
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ranking = 0.00062994327249007
keywords = cancer
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8/10. Effects of radiation on the human gastrointestinal tract.

    radiation therapy directed at the abdomen may damage the digestive tract, the type and extent of injury depending on the dose of the radiation and the radiation sensitivity of the gut. Characteristic early changes are manifest in the mucosa of the gut: for later ulceration, changes in the collagen tissues and particularly in the vascular channels occur. This paper describes and characterizes injuries to the esophagus, stomach, small intestine and colon. It emphasizes the importance of recognizing radiation-induced damage to the gut which may occur early or late after radiation.
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ranking = 0.125
keywords = radiation-induced
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9/10. strongyloidiasis. When to suspect the wily nematode.

    strongyloidiasis is a tenacious soil-transmitted nematode infestation endemic in the south-eastern united states. Thirty-three cases were diagnosed in a series of 1,290 stool examinations in 971 patients at veterans Administration Medical Center, Mountain Home, tennessee. Most patients had a concurrent major illness, such as chronic lung disease, serious bacterial infection, or cancer. A minority presented with gastrointestinal symptoms alone. skin rash was uncommon. eosinophilia, IgE elevation, and skin anergy were common. Atypical presentations included severe proctitis, colitis, and exacerbation of inflammatory bowel disease. In a patient with the hyperinfection syndrome, the diagnosis was made only at autopsy. Since strongyloidiasis seems to present like an opportunistic illness, all physicians, not just those in endemic areas, should consider its presence in the appropriate setting.
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ranking = 0.00015748581812252
keywords = cancer
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10/10. Inflammatory tumours in the rectum clinically simulating cancer.

    Four patients were admitted to our department after discovery of a palpable mass in the rectal ampulla. All lesions were clinically interpreted as malignant neoplasms. Repeated examinations with biopsies showed nonspecific, inflammatory tumours in all cases. Inflammatory tumours of the rectum may occur in a number of diseases. The lesions in two patients may have their origin in the solitary ulcer of the rectum or colitis cystica profunda, while this diagnosis for certain was made in the fourth patient. The third described patient had a palpable mass in the rectal ampulla after a difficult urethral dilatation, and the mass gradually subsided without treatment. The clinical misinterpretation of inflammatory tumours as malignant neoplasms has been responsible for a considerable number of unnecessary surgical procedures.
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ranking = 0.00062994327249007
keywords = cancer
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