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Changing Aspects of Radiation Enteropathy
Leon Morgenstern, MD;
Marquis Hart, MD;
Diana Lugo, RN;
Nathan B. Friedman, MD
Arch Surg. 1985;120(11):1225-1228.
Abstract
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• Fifty-two patients with radiation enteropathy secondary to radiation for abdominal or pelvic malignant neoplasms are described. This series (1977 to 1984) is compared with a series of 50 patients from the same institution over an earlier period (1961 to 1977). Intestinal obstruction was the principal complication in both series; 96% of the patients underwent either intestinal resection or anastomotic bypass of the affected segment. Changes that have occurred since the last report are as follows: (1) changes in source of radiation energy (linear accelerator); (2) less evidence of mucosal damage; (3) increased serosal reaction ("serosal peel"); and (4) increased use of elemental diets, parenteral nutrition, and long intestinal tubes in surgical management. Since postoperative radiation injury occurs most frequently in the pelvis, new developments for the exclusion of small bowel from the pelvis during radiation are reviewed. Changes in fractionation of radiation dosage should also be considered in patients with enteric symptoms during radiation therapy.
(Arch Surg 1985;120:1225-1228)
Author Affiliations
From the Departments of Surgery (Drs Morgenstern and Hart and Ms Lugo) and Pathology (Dr Friedman), Cedars-Sinai Medical Center, Los Angeles.
Footnotes
Accepted for publication June 5, 1985.
Read before the Annual Meeting of the Southern California Chapter of the American College of Surgeons, Coronado, Calif, Jan 18, 1985.
Reprint requests to Department of Surgery, Cedars-Sinai Medical Center, 8700 Beverly Blvd, Los Angeles, CA 90048 (Dr Morgenstern).
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