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Session: ePoster: Benign Anorectal 5 (Mon8)

EP615 - Sclerotherapy treatment for rectal bleeding in a patient undergoing radiotherapy for prostatic cancer

Monday, May 12, 2025
8:38 AM – 8:43 AM PT
Location: Monitor 2, Sails Pavilion, Upper Level

    ePoster Presenter(s)

  • GG

    Giorgio Gasloli, Dr. (he/him/his)

    MD
    ASST Valle Olona, Ospedale di Busto Arsizio
    Arenzano, Liguria, Italy

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • RC

    Roberto Casieri, Dr.

    MD
    ASST Valle Olona
    Busto Arsizio, Lombardia, Italy

    Disclosure information not submitted.

    • Senior Author(s)

  • IS

    Ildo Scandroglio, Surgical Department Director

    MD
    ASST Valle Olona, presidio di Busto Arsizio
    Busto Arsizio, Lombardia, Italy

    All of the relevant financial relationships listed below have been mitigated.
    This individual has no financial relationships with ineligible companies.

    • Author(s)

  • FC

    Francesco Maria Carrano, Prof.

    Assistant Professor
    Department of Medical and Surgical Sciences and Translational Medicine and Psycology, St.Andrea Hospital, Sapienza University, Rome, Italy.
    Rome, Lazio, Italy

    Disclosure information not submitted.

All of the relevant financial relationships listed below have been mitigated.
Giorgio Gasloli, Dr.: This individual has no financial relationships with ineligible companies.
Ildo Scandroglio, Surgical Department Director: This individual has no financial relationships with ineligible companies.
Image or Table (Do Not add text here):

Purpose/Background: Sclerotherapy has recently become a popular procedure for managing hemorrhoidal bleeding, offering the advantage of being readily applicable even in patients on anticoagulant or antiplatelet therapy without the need for discontinuation.

Methods/Interventions: An 80-year-old male with grade III (Golligher)congested hemorrhoids, receiving Edoxaban 60 mg daily for atrial fibrillation, underwent hemorrhoid sclerotherapy. The patient also presented with T2c/T3a prostate cancer, scheduled for curative radiotherapy and hormone therapy. Persistent hemorrhoidal bleeding was delaying the initiation of oncological treatment. Intrahemorrhoidal sclerotherapy using 3% Polidocanol foam (prepared according to the Tessari method) was performed in the operating room under day surgery conditions (Blond technique).

Results/Outcomes: Postoperatively, the patient experienced no bleeding, reported minimal pain (VAS 1), and was discharged approximately 3 hours after the procedure. Home therapy included micronized flavonoid (1 tablet twice daily), Psyllium fiber supplement, and Mesoglycan 50 mg (1 tablet twice daily)..

The patient was re-evaluated on Day 1, showing mild tenesmus, and on Day 8, reporting overall well-being. The patient remained free of haemorrhoidal bleeding, and haemoglobin levels were normal at the onset of radiotherapy. A centering CT was performed on Day 20, with radiotherapy commencing on Day 25

Conclusion/Discussion: This case report demonstrates that sclerotherapy is an effective, safe, and simple treatment associated with home medical therapy for controlling bleeding in grade III hemorrhoids in anticoagulated patients, enabling timely initiation of oncological therapy without adverse effects. Additionally, should bleeding recur during oncological treatment, sclerotherapy can be promptly repeated to prevent disruption of cancer therapy. However, larger studies are needed to confirm these findings and assess the long-term outcomes and effectiveness across varying degrees of hemorrhoidal prolapse.