Abstract
Rectal perforation is a rare but potentially fatal complication of neoadjuvant radiotherapy for rectal cancer. Rectal perforation has been described following both short and long-course radiotherapy1,2 and is thought to be secondary to locally advanced tumour necrosis with disintegration of the rectal wall. Rarely, the ensuing para-colic inflammatory process may involve the mesenteric vessels resulting in thrombophlebitis of the inferior mesenteric vein.3 This usually manifests as air columns and thrombus within the lumen of the affected vein and can progress to porto-mesenteric thrombosis.
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