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World Journal of Emergency Medicine ›› 2019, Vol. 10 ›› Issue (4): 228-231.doi: 10.5847/wjem.j.1920-8642.2019.04.006

• Orginal Article • Previous Articles     Next Articles

Application of 4% formaldehyde under electronic colonoscope as a minimally invasive treatment of chronic hemorrhagic radiation proctitis

Yan-dong Li1, Jia-he Xu1, Jian-jiang Lin1, Wei-fang Zhu2()   

  1. 1 Division of Colon& Rectal Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
    2 Division of Dermatology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China
  • Received:2019-04-10 Accepted:2019-08-06 Online:2019-12-15 Published:2019-12-15
  • Contact: Wei-fang Zhu E-mail:numbers@zju.edu.cn

Abstract:

BACKGROUND:To investigate the effectiveness of topical application of 4% formaldehyde as a minimally invasive treatment of rectal bleeding due to chronic radiation proctitis (CRP) under direct vision of electronic colonoscope.
METHODS: The clinical data of 13 CRP patients complicated with ≥ grade II bleeding admitted to our hospital between January 2003 and December 2018 were retrospectively analyzed. Under the guidance of electronic colonoscope, 4% formaldehyde combined with 5-aminosalicylic acid (5-ASA) suppositories was topically applied. Patients were followed up for two months after treatment, and the therapeutic effectiveness was observed and analyzed.
RESULTS: The rectal bleeding due to CRP was markedly reduced after topical application of 4% formaldehyde under colonoscope in all 13 patients. The bleeding stopped after one treatment session in 11 patients and after the second session in 2 patients. 5-ASA was also applied along with the use of 4% formaldehyde. The therapeutic effectiveness was satisfactory during the 1- and 2-month follow-up period.
CONCLUSION: Topical application of 4% formaldehyde under the direct vision of colonoscope as a minimally invasive treatment for CRB-induced bleeding is a simple, effective, affordable, and repeatable technique without obvious complications, which deserves further exploration and promotion.

Key words: Radiation proctitis, Rectal bleeding, Formaldehyde