Radiation-associated ischemic coloproctitis: Report of two cases

Radiation-associated ischemic coloproctitis is a rare clinical entity cause d by vascular insufficiency to the rectosigmoid colon. If most commonly occ urs after radiotherapy for gynecological cancer. We present herein the case s of two patients mho developed radiation-associated coloproctitis with tra nsmural necrosis and eventual perforation. Perforation of the rectosigmoid colon occurred 3.5 years after radiotherapy in case 1, a 46-year-old woman, and presented as a well-defined small area of transmural necrosis. Convers ely, in case 2, a 55-year-old woman, it occurred 1.5 years after radiothera py, and presented as segmental, diffuse transmural necrosis. The lesion in case 1 had been caused by intramural vascular obliteration due to marked fi brosis of the bowel wall, while that in case 2 had been caused by occlusion of the mesenteric artery with thrombosis. Both patients underwent Hartmann 's resection without rectal excision, and survived the perforative event.