Radiation enteritis

  • Type of intestinal ischemia
  • Damage to vascular endothelial cells
  • Results in endarteritis obliterans
  • Distal ileum and pelvic loops commonly involved
  • Time interval between radiation and symptoms variable
  • Colicky abdominal pain, diarrhea, malabsorption, intermittent small intestinal obstruction
Imaging 
  • Thickening of valvulae conniventes, mural thickening, effacement of mucosal pattern, ulceration, fixation and angulation of small intestinal loops
  • Distortion of mucosal folds along anti mesenteric border of intestine due to inflamed and thickened mesentery – ‘mucosal tacking’
  • Luminal narrowing and stenosis (single or multiple)
  • Sinus and fistulae rare
  • CT: target appearance due to submucosal edema and mucosal hyperenhancement 
  • Homogeneous mural thickening suggests chronic healing fibrotic phase
Read more

Rha, Sung E., et al. “CT and MR imaging findings of bowel ischemia from various primary causes.” Radiographics 20.1 (2000): 29-42.

Theis, V. Sripadam, et al. “Chronic radiation enteritis.” Clinical Oncology 22.1 (2010): 70-83.