Progressive radiation-induced rectal injury: is there an opportunity to get out of a vicious circle? A clinical case

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Abstract

Radiation therapy is one of the main treatment option for prostate cancer used either independently or as a component of combined and complex treatment of the disease. Modern achievements make it possible to deliver doses of radiation that match the exact dimensions of the tumor for greater efficacy, with minimal exposure of the surrounding tissues, however, does not eliminate them. In most patients, clinical manifestations of chronic radiation proctitis occur during the first 2 years after radiation therapy. The article summarizes the current knowledge about pathophysiology, clinical manifestations, diagnostics and treatment options for this condition. In this paper, we present a case of complicated of chronic radiation proctitis.

About the authors

Tatyana E. Skvortsova

Mechnikov North-Western State Medical University

Author for correspondence.
Email: Tatyana.Skvortcova@szgmu.ru
ORCID iD: 0000-0002-9362-9961

канд. мед. наук, доц. каф. пропедевтики внутренних болезней, гастроэнтерологии и диетологии им. С.М. Рысса

Russian Federation, Saint Petersburg

Inna A. Oganezova

Mechnikov North-Western State Medical University

Email: Tatyana.Skvortcova@szgmu.ru
ORCID iD: 0000-0003-0844-4469

д-р мед. наук, проф., каф. пропедевтики внутренних болезней, гастроэнтерологии и диетологии им. С.М. Рысса

Russian Federation, Saint Petersburg

Olga I. Medvedeva

Mechnikov North-Western State Medical University

Email: Tatyana.Skvortcova@szgmu.ru
ORCID iD: 0000-0002-9730-7361

канд. мед. наук, доц. каф. пропедевтики внутренних болезней, гастроэнтерологии и диетологии им. С.М. Рысса

Russian Federation, Saint Petersburg

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Supplementary files

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2. Fig. 1. Colonoscopy, December 21, 2021. Fibrin deposits and proliferation of connective tissue in the area of the defect in the anterior wall of the rectum.

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3. Fig. 2. Magnetic resonance imaging of the pelvic organs, January 27, 2022. T2 VI. Thinning (defect), inflammatory changes in the anterior wall of the rectum and fluid contents.

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4. Fig. 3. Positron emission tomography, February 14, 2022. Metastasis of the TIX vertebral body.

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5. Fig. 4. Histology of colostomy, February 18, 2022. Significant thickening of the submucosal layer up to 1 mm due to signs of fibrosis (×100).

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6. Fig. 5. Colonoscopy, March 23, 2023. Connective tissue defect of the rectum.

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7. Fig. 6. Colonoscopy, March 23, 2023. Single telangiectasia of the rectum.

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