Radiation-induced hemorrhagic duodenitis successfully treated with argon plasma coagulation

Chronic radiation proctitis usually develops 3 months after therapy. Despite the lack of standard guidelines regarding treatment, argon plasma coagulation is often a safe and effective endoscopic therapy. However, rectal ulcers are a common complication after argon plasma coagulation. Nevertheless, most patients are asymptomatic and do not require additional monitoring or treatment. We report a case of an argon plasma coagulation-induced ulcer with relevant symptoms and refractory to medical treatment. The patient was treated with hyperbaric oxygen therapy and had complete resolution of the rectal ulcer. Hyperbaric oxygen therapy has shown efficacy in severe chronic proctitis and radiation-induced rectal ulcers, but no clinical report has ever been published on using hyperbaric oxygen therapy for ulcers after argon plasma coagulation. In this case, hyperbaric oxygen therapy was an effective alternative option and can be considered in patients with refractory argon plasma coagulation-induced rectal ulcers.

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COMPARISON OF ARGON PLASMA COAGULATION AND FORMALIN INSTILLATION IN THE TREATMENT OF RADIATION INDUCED HAEMORRHAGIC PROCTOCOLITIS

Journal of Cancer & Allied Specialties ◽

10.37029/jcas.v1i1.11 ◽

2015 ◽

Vol 1 (1) ◽

Author(s):

Muhammad Adnan Masood ◽

Hala Mansoor ◽

Muhammad Qayyum Khan

Keyword(s):

Argon Plasma Coagulation ◽

Tertiary Care ◽

Argon Plasma ◽

Response To Therapy ◽

Treatment Modalities ◽

Session Key ◽

Plasma Coagulation ◽

Pelvic Malignancies ◽

Radiation Induced ◽

First Session

Background: Radiotherapy is routinely used in the treatment of pelvic malignancies and about 2–5% of these patients develop radiation-induced proctitis or proctocolitis. This complication of radiotherapy is treated in different ways. Two of these treatments, argon plasma coagulation (APC) and formalin instillation, have both been reported as to be successful modalities, but data comparing them are scarce. We conducted this study to compare these two treatment options. Methods: We reviewed the charts of patients who had radiation-induced proctocolitis and who were treated endoscopically at our tertiary care cancer centre with either APC or formalin instillation. Outcomes of the two treatments were compared in terms of bleeding control after the first session of treatment, the number of sessions required and the nal response to therapy. Results: Out of a total of 26 patients presenting with haemorrhagic radiation proctocolitis, 11 were treated with APC and 15 with formalin instillation. Success after the rst session was 53% in the formalin instillation group compared to 18% in the APC-treated group. On repeated sessions, the final response to both treatment modalities was comparable. Conclusion: Efficacy of APC and formalin instillation in the treatment of haemorrhagic radiation proctocolitis is comparable although formalin showed a better outcome after the first session. Key words: Argon plasma coagulation, formalin instillation, proctitis, radiation-induced colitis

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

BMJ Case Reports ◽

10.1136/bcr-2020-238378 ◽

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.

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