Ms. Wu, 57 years old. She was admitted to the hospital with “recurrent blood in the stool with anal pain for more than 3 months after radiotherapy for cervical cancer for more than 1 year”. The patient had good results after radiotherapy for cervical cancer, and no tumor recurrence was seen on regular review. However, 3 months ago, she started to have recurrent blood in the stool, with a large amount of blood in each stool, often causing dizziness and palpitations, and had a history of several blood transfusions. He had a history of several blood transfusions, accompanied by anal pain, anal swelling, urgency and heaviness. The quality of life was seriously affected. He came to our department.
After admission, hemoglobin showed 70g/L, and colonoscopy showed “rectal mucosal congestion and edema below 15cm from the anus, uneven capillary dilatation, and multiple ulcers covered with yellow moss and oozing blood”.
He was admitted to the hospital and diagnosed with “1. radiological colitis and 2. moderate anemia”. After admission, the patient was given anemia correction and general condition improvement, and then underwent “rectal resection and anastomosis of the descending colon” to remove the diseased intestinal canal. After the operation, the patient recovered well, and the blood in the stool and anal pain were relieved significantly. There was no significant discomfort in 19 months of follow-up.
Summary: Surgery is indicated in case of serious complications of radiation enteritis, and surgical treatment broadly includes two types, namely intestinal resection with one-stage anastomosis and conservative surgery such as short circuit and stoma. There is a lot of debate about the surgical approach for radiation proctitis, and it is currently considered that resection of the diseased bowel is the most ideal treatment option if conditions permit, but there is a risk of anastomotic fistula.