A huge rectal ulcer due to argon plasma coagulation in a patient with radiation proctitis.

Revista Española De Enfermedades Digestivas : Organo Oficial De La Sociedad Española De Patología Digestiva
David Viso VidalFrancisco Jorquera Plaza

Abstract

Radiation proctitis (RP) is a complication of radiotherapy in patients with pelvic cancer. A 64-year-old male underwent brachytherapy 2 years previously due to prostate cancer. Subsequently, he developed RP which was treated with argon plasma coagulation (APC). He was subsequently hospitalized due to rectal bleeding and underwent a colonoscopy. A large deep ulcer was seen in the anterior rectum wall, in the same place where APC was performed 3 months earlier. A perforated rectal ulcer was seen via pelvic MRI. However, it was contained by the mesorrectum. Rectal ulcers after APC are uncommon, but they can develop as a result of thermal damage to an ischemic mucosa due to radiotherapy. The treatment of choice of large ulcers is surgery, with a temporary colostomy in order to aid re-epithelialization.

References

Mar 30, 2017·Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society·Shoichi YoshimizuJunko Fujisaki
Apr 16, 2019·World Journal of Gastroenterology : WJG·Qing-Hua ZhongLei Wang

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