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THERAPEUTIC APPROACH TO HEMORRHAGIC SHOCK CAUSED BY RADIATION PROCTITIS

NIKOLA KOČET ; Zavod za hitnu medicinu Varaždinske županije, Varaždin, Hrvatska
DAMIR ROŠIĆ ; Zavod za hitnu medicinu Primorsko-goranske županije, Rijeka, Hrvatska
VIŠNJA NESEK ADAM orcid.org/0000-0002-6521-4136 ; Klinička bolnica Sveti Duh, Klinika za anesteziologiju, reanimatologiju i intenzivno liječenje, Zagreb, Klinička bolnica Sveti Duh, Objedinjeni hitni prijam, Zagreb, Sveučilište J. J. Strossmayera u Osijeku, Medicinski fakultet, Osijek, Hrvatska
TATJANA GORANOVIĆ ; Klinička bolnica Sveti Duh, Klinika za anesteziologiju, reanimatologiju i intenzivno liječenje, Zagreb, Sveučilište J. J. Strossmayera u Osijeku, Medicinski fakultet, Osijek, Hrvatska
MARIJA PLEŠE ; Zavod za hitnu medicinu Varaždinske županije, Varaždin, Hrvatska
LUCIJA STOJČIĆ ; Nastavni zavod za hitnu medicinu Grada Zagreba, Zagreb, Hrvatska

Sažetak

Radiation proctitis indicates infl ammation and damage to lower parts of the colon that occur after exposure to x-ray radiation or other ionizing radiation in the context of radiation therapy of malignant pelvic tumors. Studies show that 50%-70% of patients develop acute and 5%-11% chronic gastrointestinal impairment. The mechanism of injury involves direct damage to the DNA molecule and formation of free radical oxygen that damages mucosa, submucosa and muscle layer, and eventually the serous intestinal lining. In this article, we present a patient in whom hemorrhagic radiation proctitis developed 2.5 years after radiation therapy for prostate carcinoma, which was followed by massive bleeding and hemorrhagic shock. Although there is no standard treatment regimen, there are certain therapeutic options that are currently used in the treatment of hemorrhagic radiation proctitis, and include the use of anti-infl ammatory drugs and antioxidants, tranexamic acid, local use of formalin, slip-shaped corticosteroid, argon plasma coagulation, radiofrequency ablation, hyperbaric oxygen and surgical procedure. On the basis of the present case, the issue of surgical treatment and the extreme need for it are highlighted.

Ključne riječi

radiation proctitis; radiotherapy; hemorrhagic shock; tranexamic acid

Hrčak ID:

236633

URI

https://hrcak.srce.hr/236633

Datum izdavanja:

16.3.2020.

Podaci na drugim jezicima: hrvatski

Posjeta: 2.093 *