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Radiation Enteritis and Colitis
Atif Zaheer, MD, FSARMichael P. Federle, MD, FACR
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Definitions

              • Damage of small bowel or colonic mucosa and wall due to therapeutic or excessive irradiation
              • Chronic radiation enteritis/colitis: Late intestinal toxicity after radiotherapy

            IMAGING

            • General Features

              • Radiographic Findings

                • CT Findings

                  • MR Findings

                    • Other Modality Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Staging, Grading, & Classification

                              • Gross Pathologic & Surgical Features

                                • Microscopic Features

                                  CLINICAL ISSUES

                                  • Presentation

                                    • Demographics

                                      • Natural History & Prognosis

                                        • Treatment

                                          DIAGNOSTIC CHECKLIST

                                          • Consider

                                            • Image Interpretation Pearls

                                              Selected References

                                              1. Hale MF: Radiation enteritis: from diagnosis to management. Curr Opin Gastroenterol. 36(3):208-14, 2020
                                              2. Loge L et al: Radiation enteritis: diagnostic and therapeutic issues. J Visc Surg. 157(6):475-85, 2020
                                              3. Chater C et al: Chronic radiation enteritis. J Visc Surg. 156(2):175-6, 2019
                                              4. Harb AH et al: Radiation enteritis. Curr Gastroenterol Rep. 16(5):383, 2014
                                              5. Qin Q et al: Clinical risk factors for late intestinal toxicity after radiotherapy: a systematic review protocol. Syst Rev. 2:39, 2013
                                              6. Shadad AK et al: Gastrointestinal radiation injury: symptoms, risk factors and mechanisms. World J Gastroenterol. 19(2):185-98, 2013
                                              7. Rodríguez ML et al: Gastrointestinal toxicity associated to radiation therapy. Clin Transl Oncol. 12(8):554-61, 2010
                                              8. Birgisson H et al: Late gastrointestinal disorders after rectal cancer surgery with and without preoperative radiation therapy. Br J Surg. 95(2):206-13, 2008
                                              9. Kountouras J et al: Recent advances in the management of radiation colitis. World J Gastroenterol. 14(48):7289-301, 2008
                                              10. Lesperance RN et al: Colorectal complications of external beam radiation versus brachytherapy for prostate cancer. Am J Surg. 195(5):616-20; discussion 620, 2008
                                              11. Baxter NN et al: Postoperative irradiation for rectal cancer increases the risk of small bowel obstruction after surgery. Ann Surg. 245(4):553-9, 2007
                                              12. Beasley M et al: Complications of radiotherapy: improving the therapeutic index. Cancer Imaging. 5(1):78-84, 2005
                                              13. Chen S et al: Small bowel CT fat density target sign in chronic radiation enteritis. Australas Radiol. 47(4):450-2, 2003
                                              14. Low RN et al: Distinguishing benign from malignant bowel obstruction in patients with malignancy: findings at MR imaging. Radiology. 228(1):157-65, 2003
                                              15. Bismar MM et al: Radiation enteritis. Curr Gastroenterol Rep. 4(5):361-5, 2002
                                              16. Horton KM et al: CT of nonneoplastic diseases of the small bowel: spectrum of disease. J Comput Assist Tomogr. 23(3):417-28, 1999
                                              17. Capps GW et al: Imaging features of radiation-induced changes in the abdomen. Radiographics. 17(6):1455-73, 1997
                                              18. Bluemke DA et al: Complications of radiation therapy: CT evaluation. Radiographics. 11(4):581-600, 1991
                                              19. Mendelson RM et al: The radiological features of chronic radiation enteritis. Clin Radiol. 36(2):141-8, 1985
                                              Related Anatomy
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                                              Related Differential Diagnoses
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                                              References
                                              Tables

                                              Tables

                                              KEY FACTS

                                              • Terminology

                                                • Imaging

                                                  • Top Differential Diagnoses

                                                    • Pathology

                                                      • Clinical Issues

                                                        TERMINOLOGY

                                                        • Definitions

                                                          • Damage of small bowel or colonic mucosa and wall due to therapeutic or excessive irradiation
                                                          • Chronic radiation enteritis/colitis: Late intestinal toxicity after radiotherapy

                                                        IMAGING

                                                        • General Features

                                                          • Radiographic Findings

                                                            • CT Findings

                                                              • MR Findings

                                                                • Other Modality Findings

                                                                  • Imaging Recommendations

                                                                    DIFFERENTIAL DIAGNOSIS

                                                                      PATHOLOGY

                                                                      • General Features

                                                                        • Staging, Grading, & Classification

                                                                          • Gross Pathologic & Surgical Features

                                                                            • Microscopic Features

                                                                              CLINICAL ISSUES

                                                                              • Presentation

                                                                                • Demographics

                                                                                  • Natural History & Prognosis

                                                                                    • Treatment

                                                                                      DIAGNOSTIC CHECKLIST

                                                                                      • Consider

                                                                                        • Image Interpretation Pearls

                                                                                          Selected References

                                                                                          1. Hale MF: Radiation enteritis: from diagnosis to management. Curr Opin Gastroenterol. 36(3):208-14, 2020
                                                                                          2. Loge L et al: Radiation enteritis: diagnostic and therapeutic issues. J Visc Surg. 157(6):475-85, 2020
                                                                                          3. Chater C et al: Chronic radiation enteritis. J Visc Surg. 156(2):175-6, 2019
                                                                                          4. Harb AH et al: Radiation enteritis. Curr Gastroenterol Rep. 16(5):383, 2014
                                                                                          5. Qin Q et al: Clinical risk factors for late intestinal toxicity after radiotherapy: a systematic review protocol. Syst Rev. 2:39, 2013
                                                                                          6. Shadad AK et al: Gastrointestinal radiation injury: symptoms, risk factors and mechanisms. World J Gastroenterol. 19(2):185-98, 2013
                                                                                          7. Rodríguez ML et al: Gastrointestinal toxicity associated to radiation therapy. Clin Transl Oncol. 12(8):554-61, 2010
                                                                                          8. Birgisson H et al: Late gastrointestinal disorders after rectal cancer surgery with and without preoperative radiation therapy. Br J Surg. 95(2):206-13, 2008
                                                                                          9. Kountouras J et al: Recent advances in the management of radiation colitis. World J Gastroenterol. 14(48):7289-301, 2008
                                                                                          10. Lesperance RN et al: Colorectal complications of external beam radiation versus brachytherapy for prostate cancer. Am J Surg. 195(5):616-20; discussion 620, 2008
                                                                                          11. Baxter NN et al: Postoperative irradiation for rectal cancer increases the risk of small bowel obstruction after surgery. Ann Surg. 245(4):553-9, 2007
                                                                                          12. Beasley M et al: Complications of radiotherapy: improving the therapeutic index. Cancer Imaging. 5(1):78-84, 2005
                                                                                          13. Chen S et al: Small bowel CT fat density target sign in chronic radiation enteritis. Australas Radiol. 47(4):450-2, 2003
                                                                                          14. Low RN et al: Distinguishing benign from malignant bowel obstruction in patients with malignancy: findings at MR imaging. Radiology. 228(1):157-65, 2003
                                                                                          15. Bismar MM et al: Radiation enteritis. Curr Gastroenterol Rep. 4(5):361-5, 2002
                                                                                          16. Horton KM et al: CT of nonneoplastic diseases of the small bowel: spectrum of disease. J Comput Assist Tomogr. 23(3):417-28, 1999
                                                                                          17. Capps GW et al: Imaging features of radiation-induced changes in the abdomen. Radiographics. 17(6):1455-73, 1997
                                                                                          18. Bluemke DA et al: Complications of radiation therapy: CT evaluation. Radiographics. 11(4):581-600, 1991
                                                                                          19. Mendelson RM et al: The radiological features of chronic radiation enteritis. Clin Radiol. 36(2):141-8, 1985