Case Studies: Case Reports
Bowel explosion with colonic perforation during argon plasma coagulation for hemorrhagic radiation-induced proctitis,☆☆

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Case report

A 68-year-old woman was referred for treatment of radiation-induced proctitis with chronic hemorrhage. An epidermoid anal cancer diagnosed over 3 years earlier had been treated by radiotherapy (65 Gy) and chemotherapy. Rectal bleeding and tenesmus developed 15 months after completion of radiotherapy. The patient had been treated by topical application of corticosteroids without relief of symptoms. The only laboratory test abnormality was a hemoglobin of 10 g/dL (normal: 13 g/dL).

Discussion

APC is a noncontact electrocoagulation technique that allows effective and safe coagulation of various diseases of the digestive tract.2 Hemorrhagic radiation-induced proctitis is one of the main indications for APC; complete cessation or significant reduction in bleeding is achieved, respectively, in 50% to 100%, and 83% to 100% of patients.2, 3, 4, 5, 6 With treatment of colonic lesions, morbidity is usually minor and consists of gas bloating and transient abdominal or anal pain in about 10%

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Reprint requests: Emmanuel Ben Soussan, MD, Department of Gastroenterology, Rouen University Hospital, Ch. Nicolle, 1 rue de Germont 76031 Rouen Cedex, France.

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0016-5107/2003/$30.00 + 0

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