Radiation
colitis is a common consequence of pelvic radiation. Its complications may include
anemia due to chronic
bleeding requiring transfusions. Many of these patients are managed with rectal medications which are often inadequate for control.
Argon plasma coagulation (APC) has been well described for its efficacy in treating radiation
proctitis. Here we present two cases in whom APC
therapy was used to treat severe radiation
colitis. We reviewed two cases originally seen at the regional
cancer center (Cross
Cancer Institute) in Edmonton, Alberta, Canada. Both patients received pelvic radiation for recurrent
endometrial cancers and were referred for active
bleeding secondary to radiation
colitis that had required numerous transfusions. Radiation-induced
telangiectasias were found from 10-50 cm in the sigmoid colon. Both patients had significant improvement of symptoms after one session of APC treatment set at 40-60 W and gas flow of 2.0 l/min. There were no complications from the procedures. Neither patient required
blood transfusions after the treatment with improvement in their
hemoglobin levels and were doing well at 3- and 6-month follow-up. APC can be used effectively to provide immediate and sustained resolution of symptoms in patients with radiation
colitis.