General

Case 1 Spot Diagnosis - Endoscopy photo

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30 Jul 2016 - General
 

The endoscopic photo as attached was taken from the rectum from a middle aged man, who was complaining of having intermitent bright red rectal bleeding for the last three to four weeks, around 2-3 episodes per day. He has background medical history of prostate carcinoma (treated few months ago), hypertension, and type 2 diabetes mellitus. He is a smoker, smoking 20/day for the last 30 years, and drink alcohol around 16 unit per week. Flexi-sigmoidoscopy was done (photo as attached). Given the history and the endoscopy photo, what will be your diagnosis for this patien ?? Options as below:

A - Ulcerative colitis

B - Crohn's disease

C - Radiation proctitis

D - Ischaemic colitis

E - Infective colitis


Well done, yes it is Radiation Proctitis. It is due to the epithelial damage to the rectum due to radiation, with minimal or no inflammation. There are a few complications for radiation therapy, and radiation proctitis is 1 of the known complication. If the radiation proctitis is severe, and patient has significant drop in Haemoglobin level, the endoscopy treatment of using argon plasma coagulation (APC) will be effective in reducing the short term symptoms. Argon plasma coagulation should ...
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