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RADIATION INJURY OF THE BOWEL AFTER PELVIS IRRADIATION

RADIATION INJURY OF THE BOWEL AFTER PELVIS IRRADIATION,HANS DENCKER,ANDERS LUNDERQUIST,HANS OLIVECRONA,ULF TYLEN

RADIATION INJURY OF THE BOWEL AFTER PELVIS IRRADIATION  
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cervix or bladder, complications with bowel strictures and fistula formation are well known. In a report of 831 patients with car- cinoma of the uterine cervix, Strockbine et al.9 found the complications to be corre- lated with dose levels from 3,000 to 7,000 rads. In i6 patients, rectal ulcers were en- countered and inthe ulcers were associ- ated with a sigmoid stricture. Small bowel necrosis requiring bowel resection occurred in 3 patients. The bowel complications usually appeared between 6 months and 2 years after radiation therapy, and the in- cidence of small bowel necrosis was higher in patients with previous pelvic inflamma- tory disease where adhesions prevented the intestinal loops from moving during irradi- ation. Arterial damage with bowel ischemia is thought to be the cause of formation of the strictures. We have performed superior and inferior mesenteric angiography in 6 pa- tients, who have received bowel injury after pelvic irradiation, in order to study to what extent such vascular impairment could be diagnosed. The reaction of irradi- ation on the iliac arteries and their branches was reported by Breit,4 in 1970, but radi- ation injury of the bowel seems not to have been studied previously with mesenteric angiography in humans. REPORT OF CASES
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