1/6. radiation-associated ischemic coloproctitis: report of two cases.radiation-associated ischemic coloproctitis is a rare clinical entity caused by vascular insufficiency to the rectosigmoid colon. It most commonly occurs after radiotherapy for gynecological cancer. We present herein the cases of two patients who developed radiation-associated coloproctitis with transmural necrosis and eventual perforation. Perforation of the rectosigmoid colon occurred 3.5 years after radiotherapy in case 1, a 46-year-old woman, and presented as a well-defined small area of transmural necrosis. Conversely, in case 2, a 55-year-old woman, it occurred 1.5 years after radiotherapy, and presented as segmental, diffuse transmural necrosis. The lesion in case 1 had been caused by intramural vascular obliteration due to marked fibrosis of the bowel wall, while that in case 2 had been caused by occlusion of the mesenteric artery with thrombosis. Both patients underwent Hartmann's resection without rectal excision, and survived the perforative event.- - - - - - - - - - ranking = 1keywords = proctitis (Clic here for more details about this article) |
2/6. Use of hyperbaric oxygen chamber in the management of radiation-related complications of the anorectal region: report of two cases and review of the literature.PURPOSE: This article was undertaken to present two cases of nonhealing ulcers that occurred after primary radiation therapy and local excision of suspected residual or recurrent anal carcinomas. Both patients responded favorably to hyperbaric chamber treatment. review of the literature is discussed, including cause, clinical presentation, diagnosis, and options for management of radiation-related complications in the anorectal region and use of hyperbaric oxygen treatment in colorectal surgery. methods: The cases of two patients with recurrent or residual anal carcinomas were reviewed. Objective clinical, laboratory test, and intraoperative findings were implemented to define this pathologic entity precisely, results of its treatment, and management of radiation-related complications. RESULTS: The study shows clinical effectiveness of hyperbaric chamber treatment for nonhealing wounds in the previously radiated anorectal region. The refractory wounds of both our patients healed. The patients were rendered free of symptoms. CONCLUSIONS: Substantial pathologic changes in the irradiated tissues leading occasionally to nonhealing radiation proctitis are relatively infrequent consequences of radiation therapy for pelvic malignancies. Excisional and incisional biopsies of the radiation-injured tissues result in chronic ulcers accompanied by debilitating symptoms. Hyperbaric chamber treatment seemed to be a very effective means of therapy of radiation proctitis and nonhealing wounds in the involved anorectal region after conventional therapy had failed.- - - - - - - - - - ranking = 0.33333333333333keywords = proctitis (Clic here for more details about this article) |
3/6. 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.- - - - - - - - - - ranking = 1keywords = proctitis (Clic here for more details about this article) |
4/6. 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 = 0.83333333333333keywords = proctitis (Clic here for more details about this article) |
5/6. Intrarectal formalin application, an effective treatment for grade III haemorrhagic radiation proctitis.Haemorrhagic radiation proctitis (HRP) is infrequently seen amongst the patients who are either undergoing or have undergone radiotherapy to the pelvis. We treated 16 documented cases of HRP, who did not respond to conventional steroid retention enemas, with 4% formalin application. It was observed that the rectal bleeding was controlled completely in 81% cases in median follow up of 11 months (range 6-17 months) and diversion colostomy could be avoided in all the cases. The effectiveness of local formalin application in severe HRP is described in this article.- - - - - - - - - - ranking = 0.83333333333333keywords = proctitis (Clic here for more details about this article) |
6/6. Treatment of chronic post-radiation proctitis with oral administration of sucralfate.Several nonsurgical approaches to the treatment of postradiation proctitis have been described, but no effective conservative treatment has yet been established. As an alternative to the usual treatment, three cases of chronic postradiation proctitis with hemorrhage were successfully treated with oral administration of sucralfate, with resultant decreased bleeding in long term follow-up period. Oral sucralfate may provide a novel approach to the treatment of intractable postradiation proctitis.- - - - - - - - - - ranking = 1.1666666666667keywords = proctitis (Clic here for more details about this article) |