| Journal: | Revista del Hospital Juárez de México |
| Database: | PERIÓDICA |
| System number: | 000264126 |
| Authors: | Martínez Jardón, Ricardo1 Manrique, Martín Antonio Pérez Valle, Ernesto Chávez, Miguel A |
| Institutions: | 1Hospital Juárez de México, Departamento de Endoscopia, México, Distrito Federal. México |
| Year: | 2003 |
| Season: | Oct-Dic |
| Volumen: | 70 |
| Number: | 4 |
| Pages: | 148-156 |
| Country: | México |
| Language: | Español |
| Document type: | Nota breve o noticia |
| Approach: | Caso clínico, analítico |
| Spanish abstract | Antecedentes. La proctitis por radiación es una complicación problemática de la radioterapia pélvica que se presenta en hasta 75% de los pacientes sometidos a irradiación pélvica. Cinco por ciento progresan a proctitis crónica complicada por telangiectasias y hemorragia. La utilidad del formol rectal (análogo de la formalina), instilado endoscópicamente para el tratamiento del sangrado, es evaluado prospectivamente en este estudio. Metodología. Siete pacientes (mujeres) con rectorragia recurrente, recidivante y de difícil manejo secundarias a proctitis crónica hemorrágica por radiación, y candidatas a proctectomía fueron tratadas con la instilación de formol al 2%. Como tratamiento único intrarrectal vía endoscópica, en cuatro alícuotas de 20 cc cada una con un tiempo de contacto mucoso total de 15 minutos, aproximadamente. Los pacientes fueron evaluados inicialmente a los siete, 14 y 30 días en forma clínica y endoscópica y por laboratorio. Resultados. Prácticamente la totalidad de la mucosa rectal se encontró afectada en todas las pacientes, encontrándose el mayor daño mucoso en los primeros 4 cm. Por arriba de la línea dentada, extendiéndose a una mediana de 12 cm (rango de 8 a 14 cm). Una mediana de una sesión (rango de 1 a 2) se necesitó para lograr alivio completo de la rectorragia. El 100% de las pacientes, en nuestro seguimiento a ocho meses, clínicamente tuvieron éxito inicial con desaparición de la rectorragia, una paciente requirió dos instilaciones adicionales para reportar alivio completo de la rectorragia. Todas las pacientes mantuvieron sus niveles mensuales de hemoglobina, y ninguna requirió transfusión sanguínea en el periodo de seguimiento |
| English abstract | Background. The radiation proctitis represents a problematic complication of pelvic radiotherapy, which is present up to 75% of patients to whom pelvic irradiation therapy was applied. Five percent turn into a complicated chronic proctitis due to telangiectasias and hemorrhage. The usefulness of rectal formol (analogous to formalin), endoscopically instilled for bleeding treatment is prospectively evaluated on this research. Methodology. Seven patients (women) with recurrent rectal bleeding, relapsing and secondary to chronic hemorrhagic radiation proctitis and candidates to proctectomy were treated with 2% formol instillation, as a unique endoscopic intrarectal treatment, in 4 aliquots of 20 c.c., each one with about 15 minutes of mucous contact. The patients were evaluated at the beginning, at 7, 14 and 30 days after, by clinical examination, endoscopy and laboratory tests. Results. Practically, rectal mucosa was whole affected in all patient, finding the bigger damage of mucosa on the first 4 cm upon the dentate line, and was extended 12 cm in average (rank from 8 to 14 cm). A mean of one session (rank of 1 to 2) was necessary to get complete relief from rectal bleeding. A hundred percent of patients, during our 8 months follow-up, had good initial response clinically with disappearance of rectal bleeding, one patient require 2 more instillations to report a total improvement of rectal bleeding. All patients keep up their monthly hemoglobin levels and never require a blood transfusion during the follow-up period. Conclusion. Even when the study had a little sample and a short follow-up, the obtained results show that 4% formol (formalin) rectal bleeding endoscopic instillation, represents a promiser and efficacious method for severe hemorrhagic proctitis for radiation treatment, however it is required a bigger sample and more follow-up time to valuate the real impact of the formol on the evolution of the hemorrhagic proctitis due to radiation |
| Disciplines: | Medicina |
| Keyword: | Gastroenterología, Terapéutica y rehabilitación, Proctitis, Formalina, Hemorragia, Radioterapia, Recto |
| Keyword: | Medicine, Gastroenterology, Therapeutics and rehabilitation, Proctitis, Formalin, Hemorrhage, Radiotherapy, Rectum |
| Full text: | Texto completo (Ver PDF) |
