Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with a history of pelvic radiation therapy, now reporting recurrent hematochezia, tenesmus, and rectal urgency. Symptoms are consistent with chronic radiation proctopathy. No associated fever, weight loss, or change in bowel caliber. Previous endoscopic evaluation confirms friable, telangiectatic mucosa in the distal rectum.
Clinical Examination Findings
Abdomen: Soft, non-tender, non-distended, bowel sounds present. Rectal Exam: Digital rectal examination reveals no palpable masses or strictures. Anoscopy/Sigmoidoscopy: Findings include characteristic pale, friable mucosa with prominent, arborizing telangiectasias localized to the distal rectal segment. No evidence of active ulceration or malignancy.
Treatment Protocol
Plan: Argon Plasma Coagulation (APC) therapy for ablation of symptomatic telangiectasias. Procedure performed under conscious sedation. Post-procedure: Increase fiber intake, maintain adequate hydration, and avoid constipation. Follow-up in 4-6 weeks to assess for resolution of bleeding and potential need for repeat sessions.