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尼日利亚放射性直肠炎作为下消化道出血的鉴别诊断:病例系列

Radiation proctitis as a differential of lower GIT bleeding in Nigeria: A case series.

作者信息

Chukwudike Evaristus Sunday, David Nyam Paul, Obasi Emmanuel, Ogan John John, Nwoko Chinenye Unoma, Onyia Chinwe Philomena, Okonkwo Kenechukwu Chukwuemeka, Abdulkareem Lukman Olaitan, Adiri Winnifred Njideka, Egbo Stella-Maris Chinma, Oziegbe Egbo, Davwar Pantong Mark

机构信息

University of Calabar Teaching Hospital, Calabar, Nigeria.

Jos University Teaching Hospital, Jos, Nigeria.

出版信息

Niger Med J. 2025 Apr 3;66(1):370-378. doi: 10.71480/nmj.v66i1.556. eCollection 2025 Jan-Feb.

Abstract

Pelvic radiotherapy is an acceptable and promising treatment modality for various pelvic malignancies. However, it is associated with radiation-induced injury on surrounding structures with a preference for the rectum, which is characteristically fixed in the pelvic region. Acute radiation proctitis is usually self-limiting, but in its chronic form, it can be debilitating. Recent advances in radiation therapy have significantly reduced the prevalence of radiation proctitis (RP) in high-income countries, contrary to the findings in low and middle-income countries witnessing an increasing burden of radiation proctitis. This observation can be attributed to the increased availability of radiation therapies with limited use of novel technologies designed to reduce the detrimental effects of radiotherapy and improve the detection of RP owing to improvements in endoscopic services in developing countries. This is a highlight of the trends in the presentation of RP, management modalities in various tertiary centers in Nigeria, and the limitations in care occasioned by the non-availability of argon plasma coagulation (APC) as an effective treatment modality in most tertiary health facilities in Nigeria.

摘要

盆腔放疗是治疗各种盆腔恶性肿瘤的一种可接受且有前景的治疗方式。然而,它会对周围结构造成辐射损伤,其中直肠尤为易受影响,因为直肠在盆腔区域位置相对固定。急性放射性直肠炎通常具有自限性,但慢性形式的急性放射性直肠炎可能使人虚弱。放疗技术的最新进展已显著降低了高收入国家放射性直肠炎(RP)的患病率,这与低收入和中等收入国家的情况相反,在这些国家,放射性直肠炎的负担正在增加。这一现象可归因于放射治疗的可及性提高,但旨在减少放疗有害影响的新技术使用有限,以及由于发展中国家内镜服务的改善,RP的检测有所改进。本文重点介绍了RP的发病趋势、尼日利亚各三级医疗中心的管理模式,以及尼日利亚大多数三级医疗机构因无法使用氩等离子体凝固术(APC)这种有效治疗方式而导致的护理局限性。

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