Injuries of digestive tract following radiotherapy

Injuries of digestive tract in 5 cases of cancer of the cervix uteri (women from 54 to 70 years of age, the mean age of 63) which were treated with radiation were discussed. The irradiation method was external irradiation, and one case also received internal irradiation. However, the method and doses were not clarified in detail. The period from irradiation to manifestation of the injuries was about one year in 3 cases, and 10 and 13 years in 2 cases. The primary symptoms in cases of small intestine lesion were intestinal obstruction and formation of intestinal fistula following chronic passage disorder of digestive tract, and those in cases of rectal lesion were bloody stool, proctalgia, and rectovaginal fistula. Radiosensitivity of intestinal tract, which was the cause of occurrence of injuries, was higher in order of the small intestine, the rectum, and the colon. However, it was considered that the rectum was apt to be injured, because it was fixed and was near the uterus, and that the lesion in the small intestine was small, because the small intestine was movable. Neverthless, there was fixation due to adhesion after operation, and manifestation of injuries in the small intestine was recognized. As the treatment of the lesions in the small intestine and the colon, primary resection and anastomosis were performed in the laparotomy avoiding irradiated sites of the skin, and colostomy was performed to the rectal lesion in an early stage. As a result, the prognosis in favorable. (Kanao, N.)