English

Abstract

Chronic radiation enteritis (CRE) is a complication of radiation therapy for cancer, most commonly for rectal, prostate and pelvic malignancies. It can affect both the large and small intestine, is often progressive, and may lead to a variety of clinical consequences (such as diarrhea, nausea, weight loss, abdominal pain, intestinal obstruction, perforation, abdominal abscess and fistula) depending upon the extent of injury. It usually develops six or more months after radiation therapy. This contrast with the timing of acute radiation enteritis (characterized by diarrhea and abdominal pain), which develops during shortly after radiation therapy and resolves within two to six weeks. Chronic radiation enteritis usually develops only after large doses of radiation therapy have been delivered (4500 to 5500cGY). Intestinal injury is believed to oxidative damage caused by the formation of free radicals. The primary pathophysiologic pathway of CRE is obliterative endarteritis that leads to intestinal ischemia resulting in stricture, ulceration, and occasionally fistula formation. Management for the chronic enteritis is always conservative unless severe complication is warranted. We present a case of acute intestinal obstruction following radiation therapy for cervical malignancy after six months.