Surgical approach to radiation enteritis
- Mary F Otterson, MD
Mary F Otterson, MD
- Professor, Colorectal Surgery
- Medical College of Wisconsin
Radiation to the abdomen or pelvis can damage intestinal structures, especially the ileum (radiation enteritis) and rectum (radiation proctitis). Although most early radiation injuries respond to supportive care alone, late effects of radiation, which may take months to years to manifest, often require surgical intervention.
In this topic, we discuss the surgical approach to radiation enteritis. Clinical manifestations, diagnosis, and medical management of radiation-related injuries are discussed elsewhere, including:
●Gastrointestinal toxicity (see "Overview of gastrointestinal toxicity of radiation therapy")
●Radiation proctitis (see "Clinical manifestations, diagnosis, and treatment of radiation proctitis")
●Chronic radiation enteritis (see "Diagnosis and management of chronic radiation enteritis")
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- INDICATIONS FOR SURGERY
- PREOPERATIVE PREPARATION
- Preoperative localization of lesion(s)
- - Nonbleeding patients
- - Bleeding patients
- Ureteral stenting
- Stoma marking
- Multispecialty collaboration
- SURGICAL APPROACHES
- Adequate intestinal reserve: resection
- Limited intestinal reserve: strictureplasty
- Massive adhesion: intestinal bypass
- Incurable disease: palliative procedures
- MORBIDITY AND MORTALITY
- SUMMARY AND RECOMMENDATIONS