Formalin instillation for uncontrolled radiation induced haemorrhagic proctitis

Abstract

Background: Radiation induced haemorrhagic proctitis is a well recognized complication of pelvic radiotherapy and its treatment is quite challenging.

Aim: To evaluate the efficacy of local instillation of 4% formalin in the management of uncontrolled radiation induced haemorrhagic proctitis.

Methods: This prospective study included twenty-three patients who underwent formalin instillation. We documented the control of the symptoms, assessed the outcome of the treatment, presence of complications & long term results.

Results: All patients were followed for a median of 13 months. In 15 patients, the bleeding stopped after a single treatment and in 6 after a second session. Only two patients required formalin instillation for the third time. During the follow-up period all patients were reviewed systemically with reference to the pretreatment complaints. No recurrent rectal bleeding occurred, bowel frequency was decreased and no further blood transfusion was required.

Conclusion: Local instillation of 4% formalin is an effective treatment for uncontrolled radiation induced haemorrhagic proctitis.