1/5. Chemotherapy for leukaemia following previous pelvic radiotherapy is associated with severe enteritis and haemorrhagic cystitis.We describe two patients who developed extensive ulceration, haemorrhage and necrosis of bladder or bowel following treatment with intensive chemotherapy for acute leukaemia. Major surgical intervention was required in both cases. Both patients had previously undergone pelvic radiotherapy for gynaecologic malignancy and had suffered symptoms of chronic radiation-induced cystitis and enteritis. Bowel and bladder histology showed evidence of chronic radiation cystitis or enteritis. We postulate that combined mucosal toxicity secondary to cytotoxic therapy and chronic radiation-induced damage to bowel or bladder mucosa resulted in critical ischaemia, ulceration and necrosis of bowel and bladder. Caution must be exercised in the treatment of patients receiving intensive chemotherapy if there is a history of chronic radiation enteritis or cystitis, and dosage reductions may be justified.- - - - - - - - - - ranking = 1keywords = radiation-induced (Clic here for more details about this article) |
2/5. diagnosis of small bowel radiation enteritis by capsule endoscopy.We report a case of radiation-induced enteritis of the small bowel diagnosed by capsule endoscopy. A 67-year-old woman, who had received radiotherapy for a carcinoma of cervix 10 years ago, presented with passage of tarry stool and anaemia. The gastroscopy results were normal and the small bowel enema showed no abnormalities, but colonoscopy revealed altered blood clots in the right-sided colon and in the terminal ileum. M2A capsule endoscopy was subsequently performed that showed an ulcer and stricture at the distal ileum. The capsule, however, became lodged at this stricture site caused by the stenosis. A small bowel resection was performed to remove both the diseased section and the capsule, and the patient made an uneventful recovery.- - - - - - - - - - ranking = 0.5keywords = radiation-induced (Clic here for more details about this article) |
3/5. Chronic radiation enteritis after ovarian cancer: from home parenteral nutrition to oral diet.INTRODUCTION: External beam radiation of abdominal and pelvic cavities is a current therapy for gynaecological cancer that often produces radiation-induced bowel injury and malnutrition. CASE REPORT: A 72-year old patient underwent surgery and external beam radiation therapy for an ovarian carcinoma. Two years later she was found to have intestinal pseudoobstruction related to chronic radiation enteritis and protein-energy malnutrition. Home parenteral nutrition was prescribed due to poor oral intake, but it was discontinued after 6 catheter-related sepsis and upper cava vein thrombosis. parenteral nutrition could be reintroduced after an angioplasty of that vein, and the patient was operated on with the finding of an incarcerated ileum eventration. Nowadays she maintains a normal nutritional status with oral diet. DISCUSSION: radiation enteritis can lead to perforation, fistulae or strictures of the bowel. Malnutrition is common and parenteral nutrition may be necessary. Surgery can solve these complications, achieves good survival rates and can allow stopping parenteral nutrition.- - - - - - - - - - ranking = 0.5keywords = radiation-induced (Clic here for more details about this article) |
4/5. Intestinal complications of wide field abdominal irradiation for lymphoma.We report bowel complications on a series of 32 patients treated with wide field abdominal irradiation for lymphoma between 1979 and 1983. Irradiation was preceded by chemotherapy in 30/32 patients. Fifteen of the 32 patients received total abdominal irradiation and 17/32 received upper hemi-abdominal irradiation to a dose of 20-25 Gy. A boost of 5-20 Gy to a reduced volume was added in 14/32. A special diet was prescribed from the start of irradiation. Immediate tolerance to irradiation was good in 94% of patients. Only five patients developed delayed bowel complications. Definite radiation-induced bowel changes were demonstrated in only two of these cases and other pathology was found to explain the symptomatology in the remaining three. Comparison with a previous series of 50 lymphoma patients treated with total abdominal irradiation to 30 Gy plus inverted Y boost to 10 Gy demonstrated a net improvement in the immediate tolerance and reduction in the incidence and gravity of delayed radiation-related bowel complications in the current series. The reasons for the improved early and late bowel tolerance (radiation dose and volume, etc.) as well as conditions which can mimic late radiation enteritis, will be discussed.- - - - - - - - - - ranking = 0.5keywords = radiation-induced (Clic here for more details about this article) |
5/5. Chronic radiation enteritis complicating non-Hodgkin's lymphoma.A case of radiation enteritis in a patient with non-Hodgkin's lymphoma is described. The patient's complaints suggested recurrence of her lymphoma and radiographic studies were nondiagnostic of radiation-induced enteritis, delaying diagnosis and appropriate therapy. An inadvertent error in radiotherapy technic and fibrous adhesions resulting from the staging laparotomy contributed to the radiation injury. radiation enteritis is a rare complication of irradiation of abdominal lymphoma, but it must be considered by physicians who encounter a similar situation.- - - - - - - - - - ranking = 0.5keywords = radiation-induced (Clic here for more details about this article) |