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...
Autores principales: | , , |
---|---|
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 |