Subtotal gastrectomy for diffused hemorrhagic gastritis induced by radiation, following liver resection for hilar cholangiocarcinoma. A case report

Vasileios Tatsis; Evaggelia Peponi; Georgios Papadopoulos; Periklis Tsekeris; Michael Fatouros; Georgios Glantzounis

doi:10.1016/j.ijscr.2015.11.014

Subtotal gastrectomy for diffused hemorrhagic gastritis induced by radiation, following liver resection for hilar cholangiocarcinoma. A case report

Int J Surg Case Rep. 2016:18:30-2. doi: 10.1016/j.ijscr.2015.11.014. Epub 2015 Nov 21.

Authors

Vasileios Tatsis¹, Evaggelia Peponi², Georgios Papadopoulos³, Periklis Tsekeris², Michael Fatouros⁴, Georgios Glantzounis⁴

Affiliations

¹ Department of Surgery, University Hospital of Ioannina, Stavros Niarchos Avenue, 45 500 Ioannina, Greece. Electronic address: tatsis.vasileios@hotmail.com.
² Department of Radiotherapy, University Hospital of Ioannina, Stavros Niarchos Avenue, 45 500 Ioannina, Greece.
³ Department of Anesthesiology and Postoperative Intensive Care Unit, University Hospital of Ioannina, Stavros Niarchos Avenue, 45 500 Ioannina, Greece.
⁴ Department of Surgery, University Hospital of Ioannina, Stavros Niarchos Avenue, 45 500 Ioannina, Greece.

Abstract

Introduction: A rare case of hemorrhagic gastritis induced by radiation is presented, which was resistant to conservative treatment and required subtotal gastrectomy.

Presentation of case: A 56-year-old male was initially undergone right hepatectomy, resection of the extrahepatic biliary tree, hilar lymph node dissection and hepatico-jejunostomy due to advanced hilar cholangiocarcinoma. Because of the extent of the disease, chemo-radiotherapy was administered. The patient received a total radiotherapy dose of 57.6Gy in 32 sessions. Unfortunately, diffused hemorrhagic gastritis induced by radiation was developed, which was resistant to conservative treatment (endoscopic hemostasis, transfusion). A subtotal gastrectomy was performed. The patient is in good condition 45 months after the liver resection, but with local recurrence.

Conclusion: In resistant situations to conservative treatment and recurred bleeding of diffused hemorrhagic gastritis induced by radiation, surgical management may have a role.

Keywords: Chemotherapy; Gastrectomy; Hemorrhagic gastritis induced by radiation; Radiotherapy; Surgical treatment.