Small intestine & ampulla
Inflammatory disorders
Radiation enterocolitis

Topic Completed: 1 August 2012

Minor changes: 12 March 2019

Copyright: 2003-2019,, Inc.

PubMed Search: Radiation enterocolitis small bowel

Hanni Gulwani, M.B.B.S.
Page views in 2019: 1,178
Page views in 2020 to date: 734
Cite this page: Gulwani H. Radiation enterocolitis. website. Accessed August 3rd, 2020.
Definition / general
  • Observed acutely or years after radiation therapy for cervical carcinoma, Wilms tumor, lymphoma or other peritoneal tumors
Clinical features
  • Acute: anorexia, cramps, diarrhea due to mucosal injury and malabsorption
  • Chronic: may present as inflammatory colitis or indolent; also vascular injury, ischemic fibrosis, stricture
  • Treatment: resection if severe
Gross description
  • Thickened bowel wall
Microscopic (histologic) description
  • Varies from mild epithelial damage to massive necrosis and ulceration (BMC Surg 2004;4:10)
  • Loss of columnar shape and nuclear polarity of enterocytes, nuclear pyknosis, bizarre nuclei, mucin depletion and decreased mitoses
  • Also fibroblasts and endothelium with submucosal edema but low nuclear to cytoplasmic ratio, preservation of architecture
  • No desmoplasia, no infiltrative pattern

  • Atrophic and ulcerated mucosa, ectatic blood vessels, fibrosis of submucosa and muscular wall, vascular wall thickening, vascular stenosis
  • Possible fistula formation, atherosclerosis-like changes of vasculature (subintimal lipid laden macrophages, calcification, thrombosis), hyalinization of lamina propria
Microscopic (histologic) images

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Acute changes (mice)

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