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Radiology · Radiotherapy and nuclear medicine basics: radiation proctitis
Sample itemEight months after pelvic radiotherapy for cervical cancer, a woman has recurrent rectal bleeding. Sigmoidoscopy shows friable telangiectatic mucosa. Which endoscopic treatment is appropriate?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
B. Argon plasma coagulation
Chronic radiation proctitis causes mucosal telangiectasia and bleeding months after treatment. Argon plasma coagulation ablates the bleeding vessels and is the usual endoscopic therapy.
Option by option
A. Infliximab infusion
Infliximab treats inflammatory bowel disease and is not used for radiation telangiectasia.
B. Argon plasma coagulation (correct)
Correct. Argon plasma coagulation ablates telangiectatic bleeding mucosa in chronic radiation proctitis.
C. Repeat pelvic radiotherapy
Further irradiation would worsen the injury.
D. Total colectomy
Total colectomy is excessive for a localised rectal mucosal problem.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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