radiation colitis; radiation enteropathy

Etiology: 1) radiation therapy (ionizing radiation) 2) risk factors a) hypertension b) diabetes mellitus c) atherosclerosis d) chemotherapy e) > 40 Gy of radiation f) previous chemotherapy g) adhesion h) older age Pathology: 1) involves both colon & small bowel 2) rectum is most commonly involved 3) endothelial cells of small submucosal arterioles are very sensitive to ionizing radiation 3) acute disease a) occurs immediately after radiation b) mucosa fails to regenerate c) friability, hyperemia, edema 3) subacute, 2-12 months post radiation a) endothelial swelling, proliferation, fibrinoid degeneration b) obliterative endarteritis 4) chronic a) fistulas b) abscesses c) strictures & bleeding from intestinal mucosal vessels Laboratory: - endoscopy shows atrophic mucosa with telangiectatic vessels Radiology: 1) acute disease: fine serrations of the bowel 2) chronic disease: stricture of the rectum Management: - endoscopic coagulation

General

enterocolitis radiation injury; radiation toxicity

References

Mayo Internal Medicine Board Review, 1998-99, Prakash UBS (ed) Lippincott-Raven, Philadelphia, 1998, pg 305