Surgical experience with small bowel damage secondary to pelvic radiotherapy.
BACKGROUND
Patients undergoing pelvic radiotherapy are at risk of developing radiation enteritis. This study reviewed patients with radiation enteritis referred to a specialist colorectal unit.


METHODS
Patients referred with radiation enteritis secondary to pelvic radiotherapy (July 2001 to July 2005) were analysed regarding: indication, duration, dosage/fractionation of radiotherapy, nutritional/biochemical assessment, investigation, surgery, histopathology, and hospital stay.


RESULTS
Eleven patients underwent pelvic radiotherapy. The median interval between radiotherapy and referral was 17 months. The majority were nutritionally deficient at presentation (haemoglobin < 12 g/l: 91%; magnesium < 0.75 mmol/l: 64%; albumin < 35 g/l: 91%). Eight (73%) patients had either a BMI < 20 or weight loss of >10% within 3 months prior to referral. Radiation enteritis was diagnosed by preoperative radiology, laparotomy and at histopathology. All patients underwent surgery (resection/ilesotomy/bypass) and median post-operative stay was 24 days.


CONCLUSIONS
Radiation enteritis is associated with prolonged symptoms. Majority of patients are undernourished and despite nutritional support a high morbidity is noted.
Gidwani
A L
AL
Department of Surgery, Royal Victoria Hospital, Belfast, UK. gidwanianand@hotmail.com
Gardiner
K
K
Clarke
J
J
D000328:Adult; D000368:Aged; D004751:Enteritis / Q000175:diagnosis / Q000178:diet therapy / Q000209:etiology*; D005260:Female; D006801:Humans; D007421:Intestine, Small / Q000293:injuries / Q000473:pathology / Q000528:radiation effects / Q000601:surgery*; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status; D010388:Pelvis / Q000528:radiation effects*; D011832:Radiation Injuries / Q000175:diagnosis / Q000178:diet therapy / Q000209:etiology*; D011878:Radiotherapy / Q000009:adverse effects*; D012307:Risk Factors