Intestinal failure after surgery for complicated radiation enteritis

Between 1983 and 1997, a total of 16 patients were referred to a tertiary I ntestinal Failure Unit (IFU) following surgery elsewhere for complications of radiation enteritis. Eleven were female with a mean age of 43 years (ran ge 21-71 years) and the most common primary site of malignancy was genitour inary (n = 13). Patients had undergone an average of two laparotomies (rang e 1-7 laparotomies) for complications of radiation enteritis prior to trans fer to the IFU. On admission, the principal problem in eight patients was p ersisting intestinal fistulation, four patients had continuing intestinal o bstruction and four had the short bowel syndrome after extensive intestinal resection. Only one patient had evidence of residual malignancy; this pati ent with short bowel syndrome was allowed home without invasive therapy. Of the remaining 15 patients, 12 required an abdominal surgical procedure, wh ile three were discharged without further surgery after training for home p arenteral nutrition (HPN). Following abdominal surgery, five patients died in hospital, but the remaining seven patients went home alive - including t wo further patients on HPN. Overall, of the 15 patients referred with intes tinal failure after surgery for complications of radiation enteritis and ac tively treated, one-third died in hospital and a further third required ins titution of HPN before being able to be discharged home.