Successful surgical treatment of intractable post-radiation rectal bleeding

Patients will typically present symptoms of chronic post-radiation colitis and proctitis 8–12 months after finishing their treatment. Endoscopic methods play the main role treatment bleeding caused by proctitis. Surgical is required for remained approximately 10% patients. Here we a 64 year old female with metastatic breast cancer, who was referred to us intractable rectal bleeding. Total colonoscopy rigid rectosigmoidoscopy revealed proctitis, sigmoidal telangiectasis, multiple necrotic ulcers between 15 30 cm from anal verge, also huge ishemic ulcer patchy areas about 10 verge. This abnormal irradiated part resected then mucosectomy remnant rectum, both transabdominally transanally done. We performed pull-through technique normal proximal colon region through wall finally did coloanal anastomosis. Diverting stoma not made because anastomosis in region. With this can achieve benefits such as avoidance harsh dissection frozen pelvis its consequences, avoid intra-abdominal anastomosis, there no need diverting and, most important all, definite control.