Imaging Findings in Late-Onset Rectal and Vesical Bleed in Patients Who Have Undergone Radiation Therapy for Pelvic Neoplasms
Imaging Findings in Late-Onset Rectal and Vesical Bleed
Radiation-induced vessel injury is described more than a century ago and remains a persistent clinical problem, despite advances in the field of radiation oncology. Treatment of pelvic neoplasms with radiotherapy may result in chronic radiation toxicity, especially Haemorrhagic radiation cystitis and chronic radiation proctitis. We discussed the computed tomography (CT) findings of three cases with a history of radiotherapy to the pelvis presenting with hematuria and hematochezia. Contrast-enhanced CT could diagnose the cause and site of bleed. All these patients were managed successfully by endoscopic coagulation.
Weintraub NL, Jones WK, Manka D. Understanding radiation- induced vascular disease. J Am Coll Cardiol. 2010;55(12):1237– 1239. Available from: https://doi.org/10.1016/j.jacc.2009.11.053.
Russell NS, Hoving S, Heineman S, Hage JJ, Woerdeman LAE, de Bree R, et al. Novel insights into pathological changes in muscular arteries of radiotherapy patients. Radiother Oncol. 2009;92(3):477–483. Available from: https://doi.org/10.1016/j.radonc.2009.05.021.
Greven KM, Paunesku T. Radiation complications of the pelvis. Radiation toxicity: a practical guide. Boston, MA: Springer; 2008.
Kennedy G, Heise C. Radiation Colitis and Proctitis. Clin Colon Rectal Surg. 2007;20(1):64–72. Available from: https://dx.doi.org/10.1055/s-2007-970202.
Maturen KE, Feng MU, Wasnik AP, Azar SF, Appelman HD, Francis IR, et al. Imaging Effects of Radiation Therapy in the Abdomen and Pelvis: Evaluating “Innocent Bystander” Tissues. Radio Graphics. 2013;33(2):599–619. Available from: https://dx.doi.org/10.1148/rg.332125119.
Viswanathan AN, Lee LJ, Eswara JR, Horowitz NS, Kon- stantinopoulos PA, Mirabeau-Beale KL, et al. Complications of pelvic radiation in patients treated for gynecologic malig- nancies. Cancer. 2014;120(24):3870–3883. Available from: https://dx.doi.org/10.1002/cncr.28849.
Majewski W, Tarnawski R. Acute and Late Toxicity in Radical Radiotherapy for Bladder Cancer. Clin Oncol. 2009;21(8):598– 609. Available from: https://dx.doi.org/10.1016/j.clon.2009.04.008.
Takemoto S, Shibamoto Y, Ayakawa S, Nagai A, Hayashi A, Ogino H. Treatment and prognosis of patients with late rectal bleeding after intensity-modulated radiation therapy for prostate cancer. Radiation Oncol. 2012;7:87–87. Available from: https://dx.doi.org/10.1186/1748-717x-7-87.
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