Cancer Res Treat.  2015 Apr;47(2):334-338. 10.4143/crt.2013.114.

Successful Treatment of Intractable Bleeding Caused by Radiation-Induced Hemorrhagic Gastritis Using Oral Prednisolone: A Case Report

• Yun HG
• Kim HY
• Kim DY
• Lim YJ

• KMID: 2132814
• DOI: http://doi.org/10.4143/crt.2013.114

Abstract

Radiation-induced hemorrhagic gastritis is an intractable and dangerous condition. We describe a 59-year-old female patient with radiation-induced hemorrhagic gastritis. The patient underwent postoperative radiation therapy with a dose of 54 Gy in 30 fractions after a radical operation for a Klatskin tumor. Radiation volume included the gastric antrum. Approximately three months after radiation therapy, she was admitted for melena and anemia. Esophagogastroduodenoscopy showed an area of bleeding in the gastric antrum that was so diffuse that effective laser coagulation was not feasible. After failure of various treatments and transfusion of 7,040 mL of packed red blood cells, we successfully stopped the hemorrhage using oral prednisolone treatment. Based on this case, we think that oral prednisolone treatment can be tried as a first treatment for potentially life-threatening radiation-induced hemorrhagic gastritis.

Keyword

Radiation; Hemorrhage; Gastritis; Prednisolone

MeSH Terms

Anemia
Endoscopy, Digestive System
Erythrocytes
Female
Gastritis*
Hemorrhage*
Humans
Klatskin's Tumor
Laser Coagulation
Melena
Middle Aged
Prednisolone*
Pyloric Antrum
Prednisolone

Figure

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  Fig. 1. The antrum of the stomach was included in the radiation treatment volume.

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  Fig. 2. The dose volume histogram of the radiation treatment plan. PTV, planning target volume.

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  Fig. 3. Endoscopic findings. (A) There was a diffuse edematous hyperemia and bleeding from the antrum. (B) After oral steroid therapy, active oozing of blood from hemorrhagic lesions was not noted.

Reference

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