Adult intussusception is rare and typically associated with an identifiable structural lead point. Emerging evidence suggests that herbal medications, including indigo naturalis, a component of curcumin QingDai, may be linked to gastrointestinal complications. We report a case of ascending colonic intussusception in a 42-year-old woman with ulcerative proctitis 5 weeks after initiating curcumin QingDai. Imaging confirmed the diagnosis, and surgical resection was required after failed conservative and endoscopic management. Histopathology revealed no structural lead point but showed inflammatory changes consistent with previous reports of indigo naturalis-associated injury. The temporal relationship and absence of alternative etiology support a possible association.

Radiation therapy is a cornerstone in the management of pelvic and thoracic malignancies, but injury to surrounding normal tissue remains a clinically significant source of late morbidity despite advances in treatment delivery. Radiation-induced proctitis and hemorrhagic cystitis are consequential pelvic toxicities, typically presenting months to years after treatment with rectal bleeding, diarrhea, urgency, tenesmus, hematuria, and irritative lower urinary tract symptoms. Beyond the pelvis, radiation enteritis and pneumonitis represent important gastrointestinal and pulmonary complications that may similarly impair quality of life. Although severe toxicity has become less common with contemporary treatment planning, management remains challenging because of the chronic, multifactorial nature of radiation injury and limited high-quality randomized evidence. Treatment is generally individualized according to symptom severity, affected organ, and chronicity. Medical therapies include anti-inflammatory agents, antioxidants, and topical or intravesical treatments aimed at reducing inflammation and promoting mucosal healing. For chronic hemorrhagic disease, endoscopic interventions such as argon plasma coagulation, radiofrequency ablation, laser therapy, and cryotherapy target friable or telangiectatic lesions. In refractory cases, hyperbaric oxygen therapy (HBOT) has emerged as an important salvage modality by promoting angiogenesis, neovascularization, and tissue repair in irradiated tissue. Surgery is reserved for severe, refractory disease or complications, including fistula, obstruction, or life-threatening hemorrhage. This review examines contemporary management of radiation-induced proctitis and hemorrhagic cystitis, with comparative discussion of radiation enteritis and pneumonitis. We highlight organ-specific differences in pathophysiology, presentation, medical and endoscopic therapies, HBOT, and surgical intervention, emphasizing a stepwise approach to management.

Radiotherapy is a cornerstone of cancer treatment; however, despite major technological advances, radiation-induced injury to surrounding healthy tissues remains a significant clinical challenge. Here, we developed a preclinical rat model of radiation proctitis using localized, fractionated colorectal irradiation followed by comprehensive histopathological characterization. To enable local drug delivery while minimizing systemic exposure, we engineered a self-rolling bilayer PEG-PLA film loaded with the anti-inflammatory drug prednisolone. The biomaterial was optimized for endoscopic implantation into the irradiated colorectum, providing a minimally invasive therapeutic approach. Local administration of prednisolone significantly reduced the secretion of pro-inflammatory cytokines, including IL-1β, within the colonic mucosa, demonstrating the efficacy of the device in attenuating radiation-induced inflammation. Beyond prednisolone delivery, this adaptable platform could support localized administration of a broad range of therapeutic agents, including biologics or other compounds whose systemic use is limited by toxicity, poor tolerability, or high cost.

Solitary rectal ulcer syndrome (SRUS) is a rare benign disorder of the rectum strongly associated with chronic straining and rectal mucosal prolapse, which may be overt or occult. Its endoscopic appearance is highly variable, and atypical presentations can create significant diagnostic challenges, particularly in immunocompromised patients in whom infectious etiologies must be systematically excluded. We report a case of SRUS presenting as simultaneous contralateral kissing rectal ulcers in an HIV positive patient. Histopathology demonstrated the characteristic triad of fibromuscular obliteration of the lamina propria, smooth muscle extension between distorted crypts, and muscularis mucosae hypertrophy, establishing occult internal mucosal prolapse as the underlying mechanism. Comprehensive infectious evaluation including targeted testing for cytomegalovirus, herpes simplex virus, Neisseria gonorrhoeae, and Chlamydia trachomatis including lymphogranuloma venereum serovars was entirely negative. The patient achieved complete symptomatic resolution on conservative therapy with psyllium fiber supplementation at 2-month follow-up. This case illustrates an uncommon endoscopic presentation of SRUS, the diagnostic importance of histopathology in the absence of visible mucosal prolapse, and a systematic infectious exclusion approach in an HIV positive patient that may serve as a clinical reference for similar presentations.

Background and Study Aims Argon plasma coagulation (APC) is an established ablation technique, but limited by tangential probe orientation. ArgoCap was developed to allow precise, safe, and reproducible APC through visualizing the argon beam, shielding the probe, maintaining a defined distance, and enabling hybrid APC procedures. This study aimed to evaluate the clinical feasibility and safety of ArgoCap across multiple indications. Patients and Methods Between January 2022 and May 2025, 54 APC procedures using the ArgoCap were performed at three expert centers. Indications included Barrett's mucosa, ectopic gastric mucosa, gastric angioectasia, gastric antral vascular ectasia, radiation proctitis, and other indications. Primary endpoint was technical success, defined as access to the lesions and macroscopically complete ablation. Secondary endpoints included technical complications, adverse events, and procedural time. Results The majority of lesions were located in the esophagus (70%), followed by stomach (19%) and rectum (11%). Median lesion size was 13 mm (range 2-240 mm). Median ablation and procedure times were 8 min (2-15 min) and 25 min (8-75 min), respectively. Technical success was achieved in 47 cases (87%); subtotal ablation (>90% of the lesion) was possible in 52 cases (96%). Technical difficulties occurred in 1 case (2%); primary complication (ulceration with subsequent bleeding) was observed in 1 case (2%). Conclusions The ArgoCap enables easy and precise APC in the upper and lower gastrointestinal tract across multiple indications. It facilitates lesion access and visualization, reduces unintended mucosal contact, and allows hybrid APC procedures.

Rectal involvement in gastrointestinal tuberculosis (TB) is uncommon and may mimic inflammatory bowel disease or nonspecific proctitis, leading to diagnostic uncertainty. We report the case of an 18-year-old immunocompetent man presenting with chronic increased stool frequency and mucus passage, occasionally blood-streaked, without constitutional symptoms. Colonoscopy revealed nonspecific proctitis. Histopathological examination demonstrated confluent granulomas with Langhans giant cells. Microbiological confirmation including GeneXpert was negative. In view of the strongly suggestive histopathological findings and the endemic setting, a diagnosis of probable isolated TB was made, and anti-tubercular therapy was initiated. Probable rectal TB should be considered in the differential diagnosis of chronic proctitis, even in the absence of systemic features. Histopathology remains crucial, particularly in endemic regions where microbiological tests may be negative.