Rectal ulcer: Due to ketoprofen, argon plasma coagulation and prostatic brachytherapy

Abstract

Prostatic brachytherapy with permanent seed implants is a recent and safe radiation therapy technique associated with radiation-induced digestive disease. Argon plasma coagulation procedure is a validated modality in the management of haemorrhagic radiation proctitis, which is known to occasionally induce chronic rectal ulcers. We report here an original case report of an acute painful rectal ulcer as a consequence of the combination of short-term therapy with non-steroidal anti-inflammatory drugs therapy, prostatic brachytherapy with malposition of seed implants and argon plasma coagulation procedure in a patient with haemorrhagic radiation proctitis. The description of this clinical observation is essential to recommend the discontinuation of non-steroidal anti-inflammatory drugs therapy and the control of the position of seed implants in case of prostatic brachytherapy before argon plasma coagulation for radiation-induced proctitis.

Keywords: Radiation proctitis, Prostatic brachytherapy, Argon plasma coagulation, Non-steroidal anti-inflammatory drugs

Core tip: Endoscopist should be made aware of the potential dramatic outcome when treating patients with argon plasma coagulation when they are on non-steroidal anti-inflammatory drugs and previously treated for prostate cancer with prostatic brachytherapy.