Radiation Colitis with Intractable Diarrhea Due to Enterorectal Fistula: Report of a Case

輻射線大腸炎引發之小腸直腸瘻管併難治性大量腹瀉：－病例報告

江宗賢(Tsung-Hsien Chiang) ； 李宜家(Yi-Chia Lee) ； 邱瀚模(Han-Mo Chiu) ； 林肇堂(Jaw-Town Lin) ； 王秀伯(Hsiu-Po Wang)

《臺灣消化醫學雜誌》 22卷2期 (2005/06) Pp. 114-120

https://doi.org/10.6557/GJT.200506_22(2).0001

摘要

單獨體外放射治療或合併化療及外科手術對許多骨盆腔惡性腫瘤，是可治癒及有效的療法。然而，體外放射治療胃腸道傷害引起消化道潰瘍、瘻管、狹窄及吸收不良等威脅生命的併發症，而且也直接影響病人的生活品質。我們報告一位曾經接受放射治療的77歲男性直腸癌患者，他併發小腸直腸瘻管生成，進而引發難治性大量腹瀉及低容性急性腎衰竭。我們也對過去文獻作一回顧，來探討瘻管之成因及其可行之解決之道。雖然病人接受支持性療法，包括血液透析、全靜脈營養供給等等，之後還是死於敗血症。小腸直腸瘻管雖然是輻射線大腸炎之罕見併養症，但也須仔細的作診斷和小心的處理。

關鍵字

腹瀉 ； 輻射線大腸炎 ； 小腸直陽瘻管

並列摘要

Radiotherapy alone or in combination with chemotherapy and surgery is effective in the treatment of pelvic malignancies. However, bowel injuries resulting in ulcer, fistula, stricture, and malabsorption are potential life-threatening complications, which can impact the quality of life. We describe the case of a 77-year-old man who received radiation therapy for rectal carcinoma that was subsequently complicated by enterorectal fistula, presenting as intractable diarrhea and acute renal failure. The underlying mechanisms and treatment options are reviewed. Although the patient was treated with hemodialysis, total parenteral nutrition, and other conservative measures, he expired finally. Enterorectal fistula, which is a rare complication of radiation therapy, should be critically diagnosed and managed with caution.

並列關鍵字

diarrhea ； radiation colitis ； enterorectal fistula