Case Report
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World J Gastroenterol. Dec 28, 2012; 18(48): 7402-7404
Published online Dec 28, 2012. doi: 10.3748/wjg.v18.i48.7402
Treatment of radiation-induced hemorrhagic gastritis with prednisolone: A case report
Lan Zhang, Xiao-Ying Xie, Yan Wang, Yan-Hong Wang, Yi Chen, Zheng-Gang Ren
Lan Zhang, Xiao-Ying Xie, Yan Wang, Yan-Hong Wang, Yi Chen, Zheng-Gang Ren, Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai 200032, China
Lan Zhang, Xiao-Ying Xie, Yan Wang, Yan-Hong Wang, Yi Chen, Zheng-Gang Ren, Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, Fudan University, Shanghai 200032, China
Author contributions: Zhang L did literature search and wrote the paper; Xie XY and Wang Y followed up the patient; Wang YH and Chen Y did literature search; and Ren ZG revised the manuscript.
Correspondence to: Zheng-Gang Ren, MD, PhD, Liver Cancer Institute, Zhongshan Hospital, Fudan University, 136 Xue Yuan Road, Shanghai 200032, China. ren.zhenggang@zs-hospital.sh.cn
Telephone: +86-21-4041990 Fax: +86-21-64037181
Received: August 1, 2012
Revised: August 17, 2012
Accepted: September 28, 2012
Published online: December 28, 2012
Abstract

Radiation-induced gastritis is an infrequent cause of gastrointestinal bleeding. It is a serious complication arising from radiation therapy, and the standard treatment method has not been established. The initial injury is characteristically acute inflammation of gastric mucosa. We presented a 46-year-old male patient with hemorrhagic gastritis induced by external radiotherapy for metastatic retroperitoneal lymph node of hepatocellular carcinoma. The endoscopic examination showed diffuse edematous hyperemicmucosa with telangiectasias in the whole muscosa of the stomach and duodenal bulb. Multiple hemorrhagic patches with active oozing were found over the antrum. Anti-secretary therapy was initiated for hemostasis, but melena still occurred off and on. Finally, he was successfully treated by prednisolone therapy. We therefore strongly argue in favor of perdnisolone therapy to effectively treat patients with radiation-induced hemorrhagic gastritis.

Keywords: Hemorrhagic gastritis, Radiation, Prednisolone, Hepatocellular carcinoma, Gastrointestinal bleeding