Suzuki Keita, Ikenoyama Yohei, Hirasawa Toshiaki, Yoshimizu Shoichi, Horiuchi Yusuke, Ishiyama Akiyoshi, Yoshio Toshiyuki, Taguchi Senzo, Yoshioka Yasuo, Fujisaki Junko
Department of Gastroenterology, Cancer Institute Hospital, 3-8-31 Ariake, Koto, Tokyo, 135-8550, Japan.
Department of Radiation Oncology, Cancer Institute Hospital, Tokyo, Japan.
Clin J Gastroenterol. 2023 Apr;16(2):152-158. doi: 10.1007/s12328-022-01750-1. Epub 2022 Dec 31.
Radiation-induced hemorrhagic gastritis is a relatively uncommon complication of irradiation that can be severe. However, appropriate treatment guidelines have not yet been established because of the small number of known cases. At our hospital, we encountered nine cases of radiation-induced hemorrhagic gastritis between July 2005 and July 2018. All patients initially underwent argon plasma coagulation (APC) for hemostasis. The treatment was highly effective, and hemostasis was successfully achieved in eight of the cases. Hemostasis could not be achieved in one case treated with APC; therefore, surgical resection was required. This patient had risk factors, such as liver cirrhosis and a history of abdominal surgery. Our case series suggests that APC is an effective hemostatic method that should be considered as the initial treatment option for radiation-induced hemorrhagic gastritis; however, surgical resection may be considered when the patient is at high risk for rebleeding.
放射性出血性胃炎是一种相对罕见但可能很严重的放疗并发症。然而,由于已知病例数量较少,尚未制定适当的治疗指南。在我院,2005年7月至2018年7月期间共遇到9例放射性出血性胃炎患者。所有患者最初均接受氩等离子体凝固术(APC)止血。该治疗效果显著,8例患者成功实现止血。1例接受APC治疗的患者未能止血,因此需要进行手术切除。该患者存在肝硬化和腹部手术史等危险因素。我们的病例系列表明,APC是一种有效的止血方法,应被视为放射性出血性胃炎的初始治疗选择;然而,当患者再出血风险较高时,可考虑手术切除。