Year 2020 / Volume 112 / Number 8
Letter
A huge rectal ulcer due to argon plasma coagulation in a patient with radiation proctitis

661-662

DOI: 10.17235/reed.2020.6798/2019

David Viso Vidal, Marcos Jiménez Palacios, Francisco 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.
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References
1. Ravizza D, Fiori G, Trovato C, et al. Frequency and outcomes of rectal ulcers during argon plasma coagulation for chronic radiation-induced proctopathy. Gastrointest Endosc 2003: 57: 519-25.
2. Martos C, Olivencia P, Patón R, et al. Úlcera rectal postradioterapia complicada con infección por Actinomyces. Rev Esp Enferm Dig 2016; 108: 580-81.
3. Zhong QH, Liu ZZ, Yuan ZX, et al. Efficacy and complications of argon plasma coagulation for hemorrhagic chronic radiation proctitis. World J Gastroenterol 2019; 25: 1618-27.
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Viso Vidal D, Jiménez Palacios M, Jorquera Plaza F. A huge rectal ulcer due to argon plasma coagulation in a patient with radiation proctitis. 6798/2019


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Publication history

Received: 07/12/2019

Accepted: 27/12/2019

Online First: 20/07/2020

Published: 30/07/2020

Article Online First time: 226 days

Article editing time: 236 days


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