IS Case 339: Radiation colitis

Amira Farouga, MD

Imaging Sciences URMC

Imaging Sciences URMC 2009
Publication Date: 2009-11-09

History

Patient is a 57-year-old female treated for cervical cancer with pelvic radiation 11 years ago and now has rectal bleeding.

Findings

Focal narrowing of mid-sigmoid colon with tapered margins. The mucosal pattern is preserved.

Diagnosis

Radiation colitis

Discussion

The colon is often affected by radiation for pelvic genitourinary tract tumors. Radiation colitis typically develops after 2-years latent period. Patient presents with rectal bleeding, pain and diarrhea.

Barium enema examination can show diffuse or focal narrowing of the rectum and sigmoid colon, usually with tapered margins. The mucosal pattern is usually preserved but may be distorted or disrupted because of edema or intramural hemorrhage.

On CT of radiation colitis, rectal stricture, widened presacral space or rectosigmoid fistula may be seen.

References

  1. Capps GW, Fulcher AS, Szucs RA, Turner MA. Imaging features of radiation-induced changes in the abdomen. Radiographics. 1997 Nov-Dec;17(6):1455-73. PMID: 9397458

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