Cargando…

Case Report: Reversal of Hyaluronic Acid Rectal Wall Infiltration with Hyaluronidase

Peri-rectal spacers provide protection to the rectum for patients receiving radiation therapy treating prostate cancers. Commonly used hydrogel spacers hold the disadvantage that they cannot be readily reversed should inadvertent injection outside of the target area occurs, potentially leading to is...

Descripción completa

Detalles Bibliográficos
Autores principales: Hong, Anne, Ischia, Joseph, Chao, Michael
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9086491/
https://www.ncbi.nlm.nih.gov/pubmed/35558509
http://dx.doi.org/10.3389/fonc.2022.870388
_version_ 1784704013822853120
author Hong, Anne
Ischia, Joseph
Chao, Michael
author_facet Hong, Anne
Ischia, Joseph
Chao, Michael
author_sort Hong, Anne
collection PubMed
description Peri-rectal spacers provide protection to the rectum for patients receiving radiation therapy treating prostate cancers. Commonly used hydrogel spacers hold the disadvantage that they cannot be readily reversed should inadvertent injection outside of the target area occurs, potentially leading to ischemia of the rectal mucosa leading to severe pain and ulceration, which can then lead to superinfection and pelvic abscess formation, and subsequently recto-prostatic fistulas. This could require major surgical intervention. New hyaluronic acid spacers are readily reversible with hyaluronidase and provide a valuable means to correct any misinjected spacer. We present a patient with prostate cancer who was planned for radiation therapy and required a rectal spacer. The hyaluronic acid rectal spacer was injected in part into the rectal wall. The patient was asymptomatic, and a sigmoidoscopy confirms healthy bowel mucosa only. The misinjected hyaluronic acid was successfully treated with targeted injection of hyaluronidase into only the rectal wall portion. Serial follow-up imaging demonstrated rapid dissolution of the misinjected hyaluronic acid with the well-positioned hyaluronic acid remaining. The patient did not experience any side effects of the hyaluronidase.
format Online
Article
Text
id pubmed-9086491
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-90864912022-05-11 Case Report: Reversal of Hyaluronic Acid Rectal Wall Infiltration with Hyaluronidase Hong, Anne Ischia, Joseph Chao, Michael Front Oncol Oncology Peri-rectal spacers provide protection to the rectum for patients receiving radiation therapy treating prostate cancers. Commonly used hydrogel spacers hold the disadvantage that they cannot be readily reversed should inadvertent injection outside of the target area occurs, potentially leading to ischemia of the rectal mucosa leading to severe pain and ulceration, which can then lead to superinfection and pelvic abscess formation, and subsequently recto-prostatic fistulas. This could require major surgical intervention. New hyaluronic acid spacers are readily reversible with hyaluronidase and provide a valuable means to correct any misinjected spacer. We present a patient with prostate cancer who was planned for radiation therapy and required a rectal spacer. The hyaluronic acid rectal spacer was injected in part into the rectal wall. The patient was asymptomatic, and a sigmoidoscopy confirms healthy bowel mucosa only. The misinjected hyaluronic acid was successfully treated with targeted injection of hyaluronidase into only the rectal wall portion. Serial follow-up imaging demonstrated rapid dissolution of the misinjected hyaluronic acid with the well-positioned hyaluronic acid remaining. The patient did not experience any side effects of the hyaluronidase. Frontiers Media S.A. 2022-04-26 /pmc/articles/PMC9086491/ /pubmed/35558509 http://dx.doi.org/10.3389/fonc.2022.870388 Text en Copyright © 2022 Hong, Ischia and Chao https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Hong, Anne
Ischia, Joseph
Chao, Michael
Case Report: Reversal of Hyaluronic Acid Rectal Wall Infiltration with Hyaluronidase
title Case Report: Reversal of Hyaluronic Acid Rectal Wall Infiltration with Hyaluronidase
title_full Case Report: Reversal of Hyaluronic Acid Rectal Wall Infiltration with Hyaluronidase
title_fullStr Case Report: Reversal of Hyaluronic Acid Rectal Wall Infiltration with Hyaluronidase
title_full_unstemmed Case Report: Reversal of Hyaluronic Acid Rectal Wall Infiltration with Hyaluronidase
title_short Case Report: Reversal of Hyaluronic Acid Rectal Wall Infiltration with Hyaluronidase
title_sort case report: reversal of hyaluronic acid rectal wall infiltration with hyaluronidase
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9086491/
https://www.ncbi.nlm.nih.gov/pubmed/35558509
http://dx.doi.org/10.3389/fonc.2022.870388
work_keys_str_mv AT honganne casereportreversalofhyaluronicacidrectalwallinfiltrationwithhyaluronidase
AT ischiajoseph casereportreversalofhyaluronicacidrectalwallinfiltrationwithhyaluronidase
AT chaomichael casereportreversalofhyaluronicacidrectalwallinfiltrationwithhyaluronidase