PDF(Pubmed)
Abstract：
BACKGROUND: Locally advanced rectal cancer (LARC) is commonly managed with neoadjuvant chemoradiation (neoCRT) followed by surgery, though not without complications. The anatomical exposure of the colon and rectum and pelvic radiotherapy poses risk, with rectal perforation and bowel obstruction, though rare, carrying life-threatening potential.
METHODS: This case highlights an exceptionally rare occurrence of concurrent rectal perforation and rectal obstruction in a 77-year-old male with LARC, just two months post neoCRT. Initial symptoms included rectal bleeding, and diagnostic procedures confirmed rectal T1N3adenocarcinoma with no metastasis. Emergency admission, prompted by complete bowel obstruction symptoms, led to discovery of rectal perforation during laparotomy, sealed by the bladder. Pathological analysis attributed the cause to radiation proctitis, reporting complete response to neoCRT with no residual tumor.
CONCLUSIONS: The rarity of both bowel obstruction and perforation as neoCRT complications, particularly in the acute phase of radiation proctitis, is noteworthy in this case. The absence of tumoral cells at the affected sites emphasizes the exceptional nature of this case.
CONCLUSIONS: This case underscores the importance of recognizing acute post neoCRT injuries as potentially life-threatening complications, emphasizing the need for heightened awareness and consideration in clinical management.
METHODS: This case highlights an exceptionally rare occurrence of concurrent rectal perforation and rectal obstruction in a 77-year-old male with LARC, just two months post neoCRT. Initial symptoms included rectal bleeding, and diagnostic procedures confirmed rectal T1N3adenocarcinoma with no metastasis. Emergency admission, prompted by complete bowel obstruction symptoms, led to discovery of rectal perforation during laparotomy, sealed by the bladder. Pathological analysis attributed the cause to radiation proctitis, reporting complete response to neoCRT with no residual tumor.
CONCLUSIONS: The rarity of both bowel obstruction and perforation as neoCRT complications, particularly in the acute phase of radiation proctitis, is noteworthy in this case. The absence of tumoral cells at the affected sites emphasizes the exceptional nature of this case.
CONCLUSIONS: This case underscores the importance of recognizing acute post neoCRT injuries as potentially life-threatening complications, emphasizing the need for heightened awareness and consideration in clinical management.
摘要：
背景：局部晚期直肠癌（LARC）通常采用新辅助放化疗（neoCRT），然后进行手术治疗，虽然不是没有并发症。结肠和直肠的解剖暴露和盆腔放疗会带来风险，直肠穿孔和肠梗阻，虽然罕见，携带着威胁生命的潜能.
方法：该病例突出了一名77岁男性LARC患者并发直肠穿孔和直肠梗阻的罕见病例，就在NeoCRT后两个月。最初的症状包括直肠出血,诊断程序证实直肠T1N3腺癌无转移。急诊入院,由完全的肠梗阻症状引起，导致在剖腹手术中发现直肠穿孔，被膀胱密封。病理分析将原因归结于放射性直肠炎,报告neoCRT完全缓解，无残留肿瘤。
结论：罕见的肠梗阻和穿孔作为新CRT并发症，特别是在放射性直肠炎的急性期，在这种情况下值得注意。在受影响的部位不存在肿瘤细胞强调了这种情况的特殊性质。
结论：此案例强调了将新CRT后急性损伤视为潜在危及生命的并发症的重要性，强调在临床管理中需要提高认识和考虑。
方法：该病例突出了一名77岁男性LARC患者并发直肠穿孔和直肠梗阻的罕见病例，就在NeoCRT后两个月。最初的症状包括直肠出血,诊断程序证实直肠T1N3腺癌无转移。急诊入院,由完全的肠梗阻症状引起，导致在剖腹手术中发现直肠穿孔，被膀胱密封。病理分析将原因归结于放射性直肠炎,报告neoCRT完全缓解，无残留肿瘤。
结论：罕见的肠梗阻和穿孔作为新CRT并发症，特别是在放射性直肠炎的急性期，在这种情况下值得注意。在受影响的部位不存在肿瘤细胞强调了这种情况的特殊性质。
结论：此案例强调了将新CRT后急性损伤视为潜在危及生命的并发症的重要性，强调在临床管理中需要提高认识和考虑。
