scholarly journals Upper GI Bleeding Secondary to Radiation Gastritis in a Patient with Preexisting Portal Hypertensive Gastropathy

2021 ◽  
pp. 513-518
Author(s):  
Samragnyi Madala ◽  
Abhishek Polavarapu ◽  
Dhineshreddy Gurala ◽  
Vivek Gumaste
Keyword(s):  
Radiation Therapy ◽  
Gastrointestinal Bleeding ◽  
Argon Plasma Coagulation ◽  
Argon Plasma ◽  
Laser Coagulation ◽  
Portal Hypertensive Gastropathy ◽  
Gastrointestinal Malignancy ◽  
Nonalcoholic Fatty Liver ◽  
Increased Risk ◽  
Radiation Induced

We commonly see patients presenting with either portal hypertensive gastropathy (PHG) or radiation gastritis. Radiation-induced hemorrhagic gastritis is an unusual lethal complication postradiation. Patients with preexisting PHG have very friable mucosa that can easily bleed after radiation for cancer treatment. There is an increased risk of bleeding with both entities present together. Our aim is to focus on treatment and possible prevention of gastrointestinal bleeding in patients with preexisting PHG undergoing radiation therapy for newly diagnosed cancer. Several therapies like prednisolone, argon plasma coagulation, laser coagulation have been proposed. There are no set guidelines for treatment. In these patients, if radiation therapy is indicated either for hepatic or gastrointestinal malignancy, it is suggested to premedicate with proton pump inhibitors or sucralfate. We describe a case of 73-year-old female who presented with upper gastrointestinal bleeding. She had liver cirrhosis secondary to nonalcoholic fatty liver disease and diagnosed with pancreatic cancer, for which she received chemoradiation. She was found to have both radiation gastritis and PHG with diffuse erythematous, edematous, congested mucosa with diffuse oozing blood in the antrum making it very challenging to treat.

Recurrent haematochezia in an 85-year-old man with hepatocellular carcinoma

2021 ◽  
Vol 14 (1) ◽  
pp. e238378
Author(s):  
Shweta Sharma ◽  
Steven Nicolaides ◽  
Ola Niewiadomski ◽  
Amanda Nicoll
Keyword(s):  
Hepatocellular Carcinoma ◽  
Radiation Therapy ◽  
Stereotactic Body Radiation Therapy ◽  
Argon Plasma Coagulation ◽  
Argon Plasma ◽  
Lower Gastrointestinal Bleeding ◽  
Dark Blood ◽  
Plasma Coagulation ◽  
Radiation Induced ◽  
Radiation Colitis

An 85-year-old man with Child-Pugh A cirrhosis secondary to non-alcoholic steatohepatitis presented to casualty with four days of painless haematochezia with dark blood without haemodynamic compromise. This was in the setting of receiving stereotactic body radiation therapy (SBRT) as treatment for his hepatocellular carcinoma (HCC).He was found to have haemorrhagic radiation colitis which was treated with argon plasma coagulation (APC). Our case demonstrates the importance of considering radiation induced colitis as a cause for painless lower gastrointestinal bleeding in patients with a background of radiation therapy for HCC. Earlier review of the imaging and consideration of this differential could have prevented the need for repeat hospitalisations and would have led to prompt colonoscopy and diagnosis.

scholarly journals Nauja formalino aplikacijos gydant radiacinį hemoraginį proktitą metodika

2008 ◽  
Vol 6 (1) ◽  
pp. 0-0
Author(s):  
Narimantas Evaldas Samalavičius
Keyword(s):  
Argon Plasma Coagulation ◽  
Treatment Strategies ◽  
Argon Plasma ◽  
Radiation Proctitis ◽  
Pelvic Malignancies ◽  
Radiation Induced ◽  
Hemorrhagic Proctitis ◽  
Number Of Treatment ◽  
Submucosal Fibrosis ◽  
Endarteritis Obliterans

Narimantas Evaldas SamalavičiusVilniaus universiteto Onkologijos instituto Chirurgijos klinika, Santariškių g. 1, LT-08406 VilniusEl paštas: [email protected] Radiacinis hemoraginis proktitas yra dėl spindulinio gydymo atsiradę tiesiosios žarnos pokyčiai, pasireiškiantys pogleivio fibroze ir obliteruojančiu endarteritu; išsivysčiusi talangiektazinė gleivinės neovaskuliarizacija lemia gleivinės trapumą ir polinkį kraujuoti. Esama įvairių radiacinio hemoraginio proktito gydymo metodikų. Pastaruoju metu efektyviausi literatūroje aprašomi metodai yra formalino aplikacija ir argono plazmos koaguliacija. Formalino aplikacija yra paprastas, pigus ir saugus gydymo būdas. Šiame straipsnyje pateikiamas naujas radiacinio hemoraginio proktito gydymo būdas – formalino aplikacijos. Pagrindiniai žodžiai: radiacinis proktitas, kraujavimas, formalino aplikacijaNew method of formalin application for the treatment of hemorrhagic radiation proctitis Narimantas Evaldas SamalavičiusVilnius University, Institute of Oncology, Clinic of Surgery,Santariškių str. 1, LT-08406 Vilnius, LithuaniaE-mail: [email protected] Radiation-induced hemorrhagic proctitis is a complication of radiotherapy for pelvic malignancies, which is caused by submucosal fibrosis, and endarteritis obliterans gives rise to telangiectatic neovasculature which is fragile and prone to bleeding. A number of treatment strategies of hemorrhagic radiation proctitis have been described. According to latest studies, formalin application and argon plasma coagulation seem to be most effective. Formalin application is a simple, inexpensive and safe method of treatment. A novel way of formalin application is described for those suffering from radiation hemorrhagic proctitis. Keywords: radiation proctitis, hemorrhage, formalin application

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