Does chronic radiation enteritis pose a diagnostic challenge? A report of three cases

Abdulzahra Hussain, Hind Mahmood, Adrian Thomas, Claire Frazer, Shamsi El-Hasani
Department of General Surgery, Princess Royal University Hospital, Farnborough Common, BR6 8ND, Kent, United Kingdom

We present three cases of late radiation enteritis, all admitted through the accident and emergency unit and managed in the surgical department. All presented with acute symptoms. Two had abdominal pain, nausea, and vomiting and in these two cases, plain radiology and computed tomography scans demonstrated small bowel obstruction. Exploratory laparotomies confirmed chronic radiation damage to the small bowel. The affected areas were resected and anastomoses were performed. The postoperative course was uneventful. The other patient presented with bleeding per rectum and a colonoscopy with biopsy of the rectum confirmed proctitis and radiation enteritis. This patient was treated conservatively and responded well. The key factor needed for successful diagnosis and management of chronic radiation enteritis is a high index of suspicion leading to appropriate use of imaging.

Hong Kong Med J 2008;14:327-30

Key words: Enteritis; Intestine, small; Radiation injuries