This 79-year-old white female patient had undergone pelvic radiation for the treatment of uterine carcinoma about one year prior to examination. The patient was referred for colonoscopy after the sudden appearance of bloody stools. During preparation for the procedure, the patient continued to pass bloody stool. Circulation remained stable.
Bleeding Teleangiectasis after Radiation
The video recording shows fresh blood in the rectum and sigmoid colon. One recognizes the fresh oozing of blood from the source. Because of the clotted blood an exact evaluation of the mucosal membrane is not possible. There is, however, an impression that there may be further sources of bleeding.
Chronic radiation injury becomes manifest between six and 12 months after radiation exposure. The mucosa is pale and dull. There is neovascularization in the form of teleangiectasis and these lesions can be very vulnerable. During the phase of active bleeding, evaluation of the finer structures is not possible.
As long as active bleeding is ongoing, evaluation of fine structures is limited. Based on her history, the suspected diagnosis of “bleeding from teleangiectasis secondary to radiation colitis” was alredy made at the first examination and confirmed in subsequent examinations. (see also Videoclip 2 - After Argon Plasma Coagulation)